Contrast Enhanced Ultrasound in CT-undetermined Focal Liver Lesions

Purpose: The purpose of this study was to examine the diagnostic accuracy of CEUS in the diagnosis of focal liver lesions, which were undetermined at CT scan. Materials and Methods: From January 2010 to December 2010, patients with CT-undetermined focal liver lesions were included in this study. A...

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Main Authors: S. W. Sandrose, S. Karstrup, O. Gerke, S. Rafaelsen
Format: Article
Language:English
Published: Georg Thieme Verlag KG 2016-11-01
Series:Ultrasound International Open
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-120272
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author S. W. Sandrose
S. Karstrup
O. Gerke
S. Rafaelsen
author_facet S. W. Sandrose
S. Karstrup
O. Gerke
S. Rafaelsen
author_sort S. W. Sandrose
collection DOAJ
description Purpose: The purpose of this study was to examine the diagnostic accuracy of CEUS in the diagnosis of focal liver lesions, which were undetermined at CT scan. Materials and Methods: From January 2010 to December 2010, patients with CT-undetermined focal liver lesions were included in this study. A total of 78 patients were evaluated: 41 men and 37 women, mean age 61.8 years; age range 30–91 years. All patients were examined with GE LOGIQ 9E ultrasound scanners with contrast-specific software, and SonoVue intravenous bolus. The standard of reference was composite consisting of: percutaneous biopsy, surgical resection, PET/CT and clinical follow-up. Results: The 78 included patients had 163 undetermined focal liver lesions, mean size 1.1 cm, range 0.1–5.3 cm. There were 18 malignant and 145 benign liver lesions, as defined by the standard of reference. In differentiating between benign vs. malignant CEUS demonstrated sensitivity, specificity, PPV, NPV and accuracy of 94.4% (95% CI: 56.3–99.5%), 99.3% (95% CI: 94.9 –99.9%), 94.4% (95% CI: 56.3–99.5%), 99.3% (95% CI: 94.9–99.9%) and 98.7% (95% CI: 94.9–99.7%), respectively. If the CEUS-inconclusive results were assumed to indicate malignancy, then sensitivity, specificity, PPV, NPV and accuracy would be 95.8% (95% CI: 66.4–99.6%), 98.6% (95% CI: 94.4–99.7%), 92.0% (95CI: 65.1–98.6%), 99.3% (95% CI: 95.0–99.9%), 98.2% (95% CI: 94.4–99.5%). Conclusion: The results of this study showed a high diagnostic accuracy for CEUS in undetermined focal liver lesions found by CT. Due to a high diagnostic accuracy of CEUS in this study, it was cautiously concluded that CEUS is useful in differentiating between malignant and benign focal liver lesions in clinical practice.
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spelling doaj.art-640eaa006b1244c59a07efc0c781fb262022-12-21T23:38:53ZengGeorg Thieme Verlag KGUltrasound International Open2509-596X2199-71522016-11-010204E129E13510.1055/s-0042-120272Contrast Enhanced Ultrasound in CT-undetermined Focal Liver LesionsS. W. Sandrose0S. Karstrup1O. Gerke2S. Rafaelsen3Health and Technology, Metropolitan University College, Copenhagen N, DenmarkDepartment of Diagnostic Imaging, Roskilde Sygehus, Roskilde, DenmarkDepartment of Nuclear Medicine, Odense University Hospital, Centre of Health Economics Research, University of Southern Denmark, Odense, DenmarkDepartment of Radiology, Vejle Hospital, University of Southern Denmark, Vejle, DenmarkPurpose: The purpose of this study was to examine the diagnostic accuracy of CEUS in the diagnosis of focal liver lesions, which were undetermined at CT scan. Materials and Methods: From January 2010 to December 2010, patients with CT-undetermined focal liver lesions were included in this study. A total of 78 patients were evaluated: 41 men and 37 women, mean age 61.8 years; age range 30–91 years. All patients were examined with GE LOGIQ 9E ultrasound scanners with contrast-specific software, and SonoVue intravenous bolus. The standard of reference was composite consisting of: percutaneous biopsy, surgical resection, PET/CT and clinical follow-up. Results: The 78 included patients had 163 undetermined focal liver lesions, mean size 1.1 cm, range 0.1–5.3 cm. There were 18 malignant and 145 benign liver lesions, as defined by the standard of reference. In differentiating between benign vs. malignant CEUS demonstrated sensitivity, specificity, PPV, NPV and accuracy of 94.4% (95% CI: 56.3–99.5%), 99.3% (95% CI: 94.9 –99.9%), 94.4% (95% CI: 56.3–99.5%), 99.3% (95% CI: 94.9–99.9%) and 98.7% (95% CI: 94.9–99.7%), respectively. If the CEUS-inconclusive results were assumed to indicate malignancy, then sensitivity, specificity, PPV, NPV and accuracy would be 95.8% (95% CI: 66.4–99.6%), 98.6% (95% CI: 94.4–99.7%), 92.0% (95CI: 65.1–98.6%), 99.3% (95% CI: 95.0–99.9%), 98.2% (95% CI: 94.4–99.5%). Conclusion: The results of this study showed a high diagnostic accuracy for CEUS in undetermined focal liver lesions found by CT. Due to a high diagnostic accuracy of CEUS in this study, it was cautiously concluded that CEUS is useful in differentiating between malignant and benign focal liver lesions in clinical practice.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-120272ceusctsensitivityspecificityultrasound
spellingShingle S. W. Sandrose
S. Karstrup
O. Gerke
S. Rafaelsen
Contrast Enhanced Ultrasound in CT-undetermined Focal Liver Lesions
Ultrasound International Open
ceus
ct
sensitivity
specificity
ultrasound
title Contrast Enhanced Ultrasound in CT-undetermined Focal Liver Lesions
title_full Contrast Enhanced Ultrasound in CT-undetermined Focal Liver Lesions
title_fullStr Contrast Enhanced Ultrasound in CT-undetermined Focal Liver Lesions
title_full_unstemmed Contrast Enhanced Ultrasound in CT-undetermined Focal Liver Lesions
title_short Contrast Enhanced Ultrasound in CT-undetermined Focal Liver Lesions
title_sort contrast enhanced ultrasound in ct undetermined focal liver lesions
topic ceus
ct
sensitivity
specificity
ultrasound
url http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-120272
work_keys_str_mv AT swsandrose contrastenhancedultrasoundinctundeterminedfocalliverlesions
AT skarstrup contrastenhancedultrasoundinctundeterminedfocalliverlesions
AT ogerke contrastenhancedultrasoundinctundeterminedfocalliverlesions
AT srafaelsen contrastenhancedultrasoundinctundeterminedfocalliverlesions