The diagnostic value of contrast-enhanced ultrasound (CEUS) for assessing hepatocellular carcinoma compared to histopathology; a retrospective single-center analysis of 119 patients¹

Issue title: Selected post-conference papers of the 39th Conference of the German Society for Clinical Microcirculation and Hemorheology, 6-7 November 2020, Hannover, Germany

Article type: Research Article

Authors: Marschner, C.A.^{a; *; #} | Zhang, L.^{a; #} | Schwarze, V.^a | Völckers, W.^a | Froelich, M.F.^b | von Münchhausen, N.^b | Schnitzer, M.L.^a | Geyer, T.^a | Fabritius, M.P.^a | Rübenthaler, J.^a | Clevert, D.-A.^a

Affiliations: [a] Department of Radiology, University Hospital, LMU Munich, Munich, Germany | [b] Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Mannheim, Germany

Correspondence: [*] Corresponding author: Constantin Marschner, Department of Radiology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany. E-mail: [email protected].

Note: [#] Both authors contributed equally to the manuscript.

Note: [1] This article was presented at the 39th Conference of the German Society for Clinical Microcirculation and Hemorheology, 6-7 November 2020, Hannover, Germany.

Abstract: BACKGROUND:HCC as the 6th most common tumor entity with the fourth highest mortality and an increasing prevalence especially due to today’s lifestyle acquires a high attention in the clinical setting. Beside CECT and CEMRI, CEUS depicts a dynamic, low-risk and radiation free imaging method that finds its use mainly in screening and active surveillance programs. PURPOSE:The aim of the retrospective study was to evaluate the diagnostic value of CEUS in correlation to pathologic findings. MATERIALS AND METHODS:Between 2004 and 2018 a total number of 119 patients were included in this retrospective single-center study. Every patient underwent CEUS in addition to a native B-mode and Color-Doppler scan. After given informed consent SonoVue® (Bracco, Milan, Italy), a second-generation blood-pool agent, was used as contrast medium. Every examination was performed and interpreted by a single experienced radiologist (EFSUMB level 3). A low mechanical index (MI) of <0,2 was chosen to obtain a good imaging quality. RESULTS:All 119 included patients received CEUS followed by a liver biopsy for inter-modality comparison. In correlation to the pathology results, CEUS showed a diagnostic sensitivity of 96,6%, a specificity of 63,9%, a PPV of 86,7% and a NPV of 88,5% by detecting liver lesions suspicious for HCC. According to the Cohen’s Kappa coefficient (k = 0,659) CEUS shows a strong inter-modality agreement in comparison to the histopathological finding. CONCLUSION:With a high sensitivity and a strong cross-modality comparability to histopathology, the CEUS is highly effective in the detection of suspicious HCC lesions.

Keywords: HCC, liver, CEUS, histopathology

DOI: 10.3233/CH-209221

Journal: Clinical Hemorheology and Microcirculation, vol. 76, no. 4, pp. 453-458, 2020