Contrast-Enhanced Ultrasound Patterns for the Non-invasive Diagnosis of Hepatocellular Carcinoma: A Prospective Multicenter Study in Histologically Proven Liver Lesions in a Real-Life Setting Demonstrating the Benefit of Extended Late Phase Observation

Schellhaas B, Bernatik T, Dirks K, Jesper D, Mauch M, Potthoff A, Zimmermann P, Strobel D (2021)

Publication Type: Journal article

Publication year: 2021

Journal

Ultrasound in Medicine and Biology Elsevier

DOI: 10.1016/j.ultrasmedbio.2021.07.010

Abstract

The hallmark for the non-invasive diagnosis of hepatocellular carcinoma (HCC) with contrast-enhanced ultrasound (CEUS) in cirrhosis is arterial phase hyperenhancement (APHE), followed by late-onset (>60 s), mild washout. Large retrospective studies report this pattern of washout to occur in the vast majority of HCCs. However, a prospective multicenter validation of these findings is still missing. Thus, we initiated a prospective multicenter validation study assessing CEUS enhancement patterns in focal liver lesions of patients at risk for HCC. We analyzed lesions that were eventually histology proven in a real-life setting. CEUS patterns were assessed for subgroups of HCC, intrahepatic cholangiocellular carcinoma (iCCA) and non-HCC, non-iCCA lesions. The diagnosis was HCC in 316 lesions (median size: 40 mm), iCCA in 26 lesions (median size: 47.5 mm) and non-HCC, non-iCCA in 53 lesions (median size: 27 mm). Overall, 85.8% of HCCs exhibited APHE. APHE followed by washout occurred in 72.8% of HCCs and 50% of iCCAs and non-HCC, non-iCCA malignancies (p < 0.05). Early and marked washout was associated more commonly with iCCA; HCCs exhibited mostly late and mild washout (onset >4–6 min in 10% of cases). Our prospective data confirm that the typical pattern of APHE followed by late-onset, mild washout occurs in the majority of HCCs.

Authors with CRIS profile

Deike Strobel Lehrstuhl für Innere Medizin I

Involved external institutions

SRH Kliniken Landkreis Sigmaringen GmbH DE Germany (DE) Medizinische Hochschule Hannover (MHH) / Hannover Medical School DE Germany (DE) Rems-Murr-Kliniken DE Germany (DE) Kreisklinik Ebersberg DE Germany (DE) SRH Wald-Klinikum Gera DE Germany (DE)

How to cite

APA:

Schellhaas, B., Bernatik, T., Dirks, K., Jesper, D., Mauch, M., Potthoff, A.,... Strobel, D. (2021). Contrast-Enhanced Ultrasound Patterns for the Non-invasive Diagnosis of Hepatocellular Carcinoma: A Prospective Multicenter Study in Histologically Proven Liver Lesions in a Real-Life Setting Demonstrating the Benefit of Extended Late Phase Observation. Ultrasound in Medicine and Biology. https://doi.org/10.1016/j.ultrasmedbio.2021.07.010

MLA:

Schellhaas, Barbara, et al. "Contrast-Enhanced Ultrasound Patterns for the Non-invasive Diagnosis of Hepatocellular Carcinoma: A Prospective Multicenter Study in Histologically Proven Liver Lesions in a Real-Life Setting Demonstrating the Benefit of Extended Late Phase Observation." Ultrasound in Medicine and Biology (2021).

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