Contrast-enhanced ultrasonography in evaluating hepatic metastases from neuroendocrine tumours

Sara Massironi, Dario Conte, Valentina Sciola, Lorena Pirola, Silvia Paggi, Mirella Fraquelli, Clorinda Ciafardini, Matilde P. Spampatti, Maddalena Peracchi

Research output: Contribution to journalArticlepeer-review


Objectives: At presentation, gastroenteropancreatic neuroendocrine tumours (GEP NETs) frequently show prognostically negative hepatic involvement. The aim of this study was to characterise hepatic metastases of GEP NETs as revealed by contrast-enhanced ultrasonography (CEUS), which allows the fine definition of the microvascular system, and to correlate these findings to the biological behaviour of the tumour. Methods: Eighteen out of 62 GEP NET patients examined between January 2007 and September 2008 had histologically proven hepatic metastases from primary ileal (#6), gastric (#1) or rectal (#1) carcinoids, pancreatic tumours (#7), or primary duodenal (#2) or occult gastrinomas (#1), and all underwent low mechanical index real-time CEUS with SonoVue ® injection. Results: Strong early enhancement in the arterial phase was observed in 15 cases (83%), and a rapid wash-out in the portal venous phase in 14 (78%). In the late venous phase, the lesions were hypoechoic in 12 cases (67%), isoechoic in five (28%), and hyperechoic in one (0.05%). The time of arterial enhancement correlated with the Ki-67 proliferative index (r s=0.516; p=0.028). Conclusions: Most of the neuroendocrine liver metastases showed increased arterial enhancement at CEUS, a behaviour that is similar to that of hepatocellular carcinomas and the opposite of that of other metastases. CEUS can be a useful diagnostic means of characterising such metastases.

Original languageEnglish
Pages (from-to)635-641
Number of pages7
JournalDigestive and Liver Disease
Issue number9
Publication statusPublished - Sep 2010


  • Carcinoids
  • Contrast-enhanced ultrasonography
  • Gastroenteropancreatic neuroendocrine tumours
  • Liver metastases
  • Pancreatic endocrine tumours

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology


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