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Clinical impact of CEUS on non-characterizable observations and observations with intermediate probability of malignancy on CT/MRI in patients at risk for HCC.
Kono, Yuko; Piscaglia, F; Wilson, S R; Medellin, A; Rodgers, S K; Planz, V; Kamaya, A; Fetzer, D T; Berzigotti, A; Sidhu, P S; Wessner, C E; Bradigan, K; Kuon Yeng Escalante, Cristina M; Siu Xiao, T; Eisenbrey, J R; Forsberg, F; Lyshchik, A.
Afiliación
  • Kono Y; Division of Gastroenterology and Hepatology, Department of Medicine, University of California, San Diego, La Jolla, CA, USA. ykono@health.ucsd.edu.
  • Piscaglia F; Division of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
  • Wilson SR; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
  • Medellin A; University of Calgary, Calgary, Canada.
  • Rodgers SK; University of Calgary, Calgary, Canada.
  • Planz V; Thomas Jefferson University Hospital, Philadelphia, PA, USA.
  • Kamaya A; Einstein Medical Center, Philadelphia, PA, USA.
  • Fetzer DT; Vanderbilt University, Nashville, TN, USA.
  • Berzigotti A; Stanford University, Stanford, CA, USA.
  • Sidhu PS; UT Southwestern Medical Center, Dallas, TX, USA.
  • Wessner CE; Department of Visceral Surgery and Medicine, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Bradigan K; Department of Imaging Sciences, School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.
  • Kuon Yeng Escalante CM; Department of Radiology, King's College Hospital, London, UK.
  • Siu Xiao T; Thomas Jefferson University Hospital, Philadelphia, PA, USA.
  • Eisenbrey JR; Thomas Jefferson University Hospital, Philadelphia, PA, USA.
  • Forsberg F; Thomas Jefferson University Hospital, Philadelphia, PA, USA.
  • Lyshchik A; Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Abdom Radiol (NY) ; 49(8): 2639-2649, 2024 Aug.
Article en En | MEDLINE | ID: mdl-38860996
ABSTRACT

BACKGROUND:

Hepatocellular carcinoma (HCC) is a unique cancer allowing tumor diagnosis with identification of definitive patterns of enhancement on contrast-enhanced imaging, avoiding invasive biopsy. However, it is still unclear to what extent Contrast-Enhanced Ultrasound (CEUS) is a clinically useful additional step when Computed tomography (CT) or Magnetic resonance imaging (MRI) are inconclusive.

METHODS:

A prospective international multicenter validation study for CEUS Liver Imaging Reporting and Data System (LI-RADS) was conducted between January 2018 and August 2021. 646 patients at risk for HCC with focal liver lesions were enrolled. CEUS was performed using an intravenous ultrasound contrast agent within 4 weeks of CT/MRI. Liver nodules were categorized based on LI-RADS (LR) criteria. Histology or one-year follow-up CT/MRI imaging results were used as the reference standard. The diagnostic performance of CEUS was evaluated for inconclusive CT/MRI scan in two scenarios for which the AASLD recommends repeat imaging or imaging follow-up observations deemed non-characterizable (LR-NC) or with indeterminate probability of malignancy (LR-3).

RESULTS:

75 observations on CT or MRI were categorized as LR-3 (n = 54) or LR-NC (n = 21) CEUS recategorization of such observations into a different LR category (namely, into one among LR-1, LR-2, LR-5, LR-M, or LR-TIV) resulted in management recommendation changes in 33.3% (25/75) and in all but one (96.0%, 24/25) observation, the new management recommendations were correct.

CONCLUSION:

CEUS LI-RADS resulted in management recommendations change in substantial number of liver observations with initial indeterminate CT/MRI characterization, identifying both non-malignant lesions and HCC, potentially accelerating the diagnostic process and alleviating the need for biopsy or follow-up imaging. CLINICALTRIALS gov number, NCT03318380.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Imagen por Resonancia Magnética / Tomografía Computarizada por Rayos X / Ultrasonografía / Carcinoma Hepatocelular / Medios de Contraste / Neoplasias Hepáticas Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Abdom Radiol (NY) Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
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PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Imagen por Resonancia Magnética / Tomografía Computarizada por Rayos X / Ultrasonografía / Carcinoma Hepatocelular / Medios de Contraste / Neoplasias Hepáticas Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Abdom Radiol (NY) Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos