Contrast-enhanced sonographic appearance of hepatocellular carcinoma in patients with cirrhosis: Comparison with contrast-enhanced helical CT appearance

Antonio Giorgio, Giovanna Ferraioli, Luciano Tarantino, Giorgio De Stefano, Vincenzo Scala, Ferdinando Scarano, Carmine Coppola, Luca Del Viscovo

Research output: Contribution to journalArticle

Abstract

OBJECTIVE. We sought to investigate the efficacy of contrast-enhanced sonography using a second-generation contrast agent for the evaluation of hepatocellular carcinoma in patients with cirrhosis by comparing the results to those obtained with contrast-enhanced helical CT. SUBJECTS AND METHODS. Between October 2002 and March 2003, 74 patients with cirrhosis (60 men and 14 women; age range, 47-80 years; mean age, 67 years) who had a single nodule of hepatocellular carcinoma were selected to be studied from a cohort of 437 patients with cirrhosis. The size range of the 74 nodules was 9-65 mm (mean, 28.2 mm). Twenty-eight (38%) were 20 mm smaller (range, 9-20 mm; mean, 16.6 mm), and 46 (62%) were larger than 20 mm (range, 21-65 mm; mean, 35.2 mm). Contrast-enhanced sonography was performed at a low mechanical index after IV administration of the contrast agent Sono-Vue. CT scans were obtained in all patients. The enhancement pattern related to tumor hypervascularity was analyzed. The chi-square test was used for statistical analysis. RESULTS. For the 28 hepatocellular carcinomas 20 mm or smaller, contrast-enhanced sonography showed 15 (53.6%) as hypervascular and 10 (35.7%) as avascular; three (10.7%) carcinomas were missed. On CT, 12 (42.9%) of the 28 hepatocellular carcinomas appeared hypervascular, 13 (46.4%) appeared hypovascular, and three (10.7%) were missed. For the 46 hepatocellular carcinomas larger than 20 mm, contrast-enhanced sonography showed 42 (91.3%) as hypervascular and four (8.7%) as avascular. On CT, 35 (76.1%) hepatocellular carcinomas appeared hypervascular, eight (17.4%) appeared hypovascular, and three (6.5%) were missed. Differences between CT appearance of hepatocellular carcinomas and contrast-enhanced sonographic appearance of the carcinomas were not statistically significant. Concordance between contrast-enhanced sonographic and CT appearances was observed in 61 (82.4%) of 74 cases. CONCLUSION. Contrast-enhanced sonography is similar to CT for detecting hepatocellular carcinoma hypervascularity. It could be complementary to conventional unenhanced sonography for evaluation of liver nodules.

Original languageEnglish
Pages (from-to)1319-1326
Number of pages8
JournalAmerican Journal of Roentgenology
Volume183
Issue number5
Publication statusPublished - Nov 2004

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Spiral Computed Tomography
Hepatocellular Carcinoma
Fibrosis
Ultrasonography
Contrast Media
Carcinoma
Chi-Square Distribution
Liver

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

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Contrast-enhanced sonographic appearance of hepatocellular carcinoma in patients with cirrhosis : Comparison with contrast-enhanced helical CT appearance. / Giorgio, Antonio; Ferraioli, Giovanna; Tarantino, Luciano; De Stefano, Giorgio; Scala, Vincenzo; Scarano, Ferdinando; Coppola, Carmine; Del Viscovo, Luca.

In: American Journal of Roentgenology, Vol. 183, No. 5, 11.2004, p. 1319-1326.

Research output: Contribution to journalArticle

Giorgio, A, Ferraioli, G, Tarantino, L, De Stefano, G, Scala, V, Scarano, F, Coppola, C & Del Viscovo, L 2004, 'Contrast-enhanced sonographic appearance of hepatocellular carcinoma in patients with cirrhosis: Comparison with contrast-enhanced helical CT appearance', American Journal of Roentgenology, vol. 183, no. 5, pp. 1319-1326.
Giorgio, Antonio ; Ferraioli, Giovanna ; Tarantino, Luciano ; De Stefano, Giorgio ; Scala, Vincenzo ; Scarano, Ferdinando ; Coppola, Carmine ; Del Viscovo, Luca. / Contrast-enhanced sonographic appearance of hepatocellular carcinoma in patients with cirrhosis : Comparison with contrast-enhanced helical CT appearance. In: American Journal of Roentgenology. 2004 ; Vol. 183, No. 5. pp. 1319-1326.
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title = "Contrast-enhanced sonographic appearance of hepatocellular carcinoma in patients with cirrhosis: Comparison with contrast-enhanced helical CT appearance",
abstract = "OBJECTIVE. We sought to investigate the efficacy of contrast-enhanced sonography using a second-generation contrast agent for the evaluation of hepatocellular carcinoma in patients with cirrhosis by comparing the results to those obtained with contrast-enhanced helical CT. SUBJECTS AND METHODS. Between October 2002 and March 2003, 74 patients with cirrhosis (60 men and 14 women; age range, 47-80 years; mean age, 67 years) who had a single nodule of hepatocellular carcinoma were selected to be studied from a cohort of 437 patients with cirrhosis. The size range of the 74 nodules was 9-65 mm (mean, 28.2 mm). Twenty-eight (38{\%}) were 20 mm smaller (range, 9-20 mm; mean, 16.6 mm), and 46 (62{\%}) were larger than 20 mm (range, 21-65 mm; mean, 35.2 mm). Contrast-enhanced sonography was performed at a low mechanical index after IV administration of the contrast agent Sono-Vue. CT scans were obtained in all patients. The enhancement pattern related to tumor hypervascularity was analyzed. The chi-square test was used for statistical analysis. RESULTS. For the 28 hepatocellular carcinomas 20 mm or smaller, contrast-enhanced sonography showed 15 (53.6{\%}) as hypervascular and 10 (35.7{\%}) as avascular; three (10.7{\%}) carcinomas were missed. On CT, 12 (42.9{\%}) of the 28 hepatocellular carcinomas appeared hypervascular, 13 (46.4{\%}) appeared hypovascular, and three (10.7{\%}) were missed. For the 46 hepatocellular carcinomas larger than 20 mm, contrast-enhanced sonography showed 42 (91.3{\%}) as hypervascular and four (8.7{\%}) as avascular. On CT, 35 (76.1{\%}) hepatocellular carcinomas appeared hypervascular, eight (17.4{\%}) appeared hypovascular, and three (6.5{\%}) were missed. Differences between CT appearance of hepatocellular carcinomas and contrast-enhanced sonographic appearance of the carcinomas were not statistically significant. Concordance between contrast-enhanced sonographic and CT appearances was observed in 61 (82.4{\%}) of 74 cases. CONCLUSION. Contrast-enhanced sonography is similar to CT for detecting hepatocellular carcinoma hypervascularity. It could be complementary to conventional unenhanced sonography for evaluation of liver nodules.",
author = "Antonio Giorgio and Giovanna Ferraioli and Luciano Tarantino and {De Stefano}, Giorgio and Vincenzo Scala and Ferdinando Scarano and Carmine Coppola and {Del Viscovo}, Luca",
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T1 - Contrast-enhanced sonographic appearance of hepatocellular carcinoma in patients with cirrhosis

T2 - Comparison with contrast-enhanced helical CT appearance

AU - Giorgio, Antonio

AU - Ferraioli, Giovanna

AU - Tarantino, Luciano

AU - De Stefano, Giorgio

AU - Scala, Vincenzo

AU - Scarano, Ferdinando

AU - Coppola, Carmine

AU - Del Viscovo, Luca

PY - 2004/11

Y1 - 2004/11

N2 - OBJECTIVE. We sought to investigate the efficacy of contrast-enhanced sonography using a second-generation contrast agent for the evaluation of hepatocellular carcinoma in patients with cirrhosis by comparing the results to those obtained with contrast-enhanced helical CT. SUBJECTS AND METHODS. Between October 2002 and March 2003, 74 patients with cirrhosis (60 men and 14 women; age range, 47-80 years; mean age, 67 years) who had a single nodule of hepatocellular carcinoma were selected to be studied from a cohort of 437 patients with cirrhosis. The size range of the 74 nodules was 9-65 mm (mean, 28.2 mm). Twenty-eight (38%) were 20 mm smaller (range, 9-20 mm; mean, 16.6 mm), and 46 (62%) were larger than 20 mm (range, 21-65 mm; mean, 35.2 mm). Contrast-enhanced sonography was performed at a low mechanical index after IV administration of the contrast agent Sono-Vue. CT scans were obtained in all patients. The enhancement pattern related to tumor hypervascularity was analyzed. The chi-square test was used for statistical analysis. RESULTS. For the 28 hepatocellular carcinomas 20 mm or smaller, contrast-enhanced sonography showed 15 (53.6%) as hypervascular and 10 (35.7%) as avascular; three (10.7%) carcinomas were missed. On CT, 12 (42.9%) of the 28 hepatocellular carcinomas appeared hypervascular, 13 (46.4%) appeared hypovascular, and three (10.7%) were missed. For the 46 hepatocellular carcinomas larger than 20 mm, contrast-enhanced sonography showed 42 (91.3%) as hypervascular and four (8.7%) as avascular. On CT, 35 (76.1%) hepatocellular carcinomas appeared hypervascular, eight (17.4%) appeared hypovascular, and three (6.5%) were missed. Differences between CT appearance of hepatocellular carcinomas and contrast-enhanced sonographic appearance of the carcinomas were not statistically significant. Concordance between contrast-enhanced sonographic and CT appearances was observed in 61 (82.4%) of 74 cases. CONCLUSION. Contrast-enhanced sonography is similar to CT for detecting hepatocellular carcinoma hypervascularity. It could be complementary to conventional unenhanced sonography for evaluation of liver nodules.

AB - OBJECTIVE. We sought to investigate the efficacy of contrast-enhanced sonography using a second-generation contrast agent for the evaluation of hepatocellular carcinoma in patients with cirrhosis by comparing the results to those obtained with contrast-enhanced helical CT. SUBJECTS AND METHODS. Between October 2002 and March 2003, 74 patients with cirrhosis (60 men and 14 women; age range, 47-80 years; mean age, 67 years) who had a single nodule of hepatocellular carcinoma were selected to be studied from a cohort of 437 patients with cirrhosis. The size range of the 74 nodules was 9-65 mm (mean, 28.2 mm). Twenty-eight (38%) were 20 mm smaller (range, 9-20 mm; mean, 16.6 mm), and 46 (62%) were larger than 20 mm (range, 21-65 mm; mean, 35.2 mm). Contrast-enhanced sonography was performed at a low mechanical index after IV administration of the contrast agent Sono-Vue. CT scans were obtained in all patients. The enhancement pattern related to tumor hypervascularity was analyzed. The chi-square test was used for statistical analysis. RESULTS. For the 28 hepatocellular carcinomas 20 mm or smaller, contrast-enhanced sonography showed 15 (53.6%) as hypervascular and 10 (35.7%) as avascular; three (10.7%) carcinomas were missed. On CT, 12 (42.9%) of the 28 hepatocellular carcinomas appeared hypervascular, 13 (46.4%) appeared hypovascular, and three (10.7%) were missed. For the 46 hepatocellular carcinomas larger than 20 mm, contrast-enhanced sonography showed 42 (91.3%) as hypervascular and four (8.7%) as avascular. On CT, 35 (76.1%) hepatocellular carcinomas appeared hypervascular, eight (17.4%) appeared hypovascular, and three (6.5%) were missed. Differences between CT appearance of hepatocellular carcinomas and contrast-enhanced sonographic appearance of the carcinomas were not statistically significant. Concordance between contrast-enhanced sonographic and CT appearances was observed in 61 (82.4%) of 74 cases. CONCLUSION. Contrast-enhanced sonography is similar to CT for detecting hepatocellular carcinoma hypervascularity. It could be complementary to conventional unenhanced sonography for evaluation of liver nodules.

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