The value of perfluorobutane contrast-enhanced ultrasound for the diagnosis of hepatocellular carcinoma

Abstract

Abstract: Objective To investigate the diagnostic performance and clinical application value of perfluorobutane contrast-enhanced Ultrasound (CEUS) for hepatocellular carcinoma (HCC). Methods The imaging data of high-risk patients with liver cancer who underwent perfluorobutane CEUS from October 2021 to July 2023 were retrospectively analyzed. The enhancement pattern, regression time and degree of the lesions in vascular phase, and the regression of the lesions in Kupffer phase were observed. In this study, HCC was diagnosed by the following two methods: (1) Arterial phase hyperenhancement (APHE) with delayed /mild washout, which was defined by the 5 categories criteria of contrast-enhanced Ultrasound Liver Imaging Reporting and Data System (CEUS LI-RADS); (2) Hypoenhancement in posterior vascular phase was taken the place of delayed or mild washout, and hyperenhancement in arterial phase (APHE) with hypoenhancement in posterior vascular phase was used as the diagnostic criteria. With the pathological results and imaging follow-up as the golden standard. The diagnostic efficacy of the two methods for diagnosing HCC was analyzed. Results There were 65 malignant lesions in 84 patients, including 55 HCC lesions. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and Youden index of CEUS LR-5 category for HCC were 76.3%, 93.1%, 82.1%, 95.5%, 67.5% and 0.695, respectively. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and Youden index of APHE combined with hypoenhancement of posterior vascular phase were 81.8%, 93.1%, 85.7%, 95.7%, 73.0% and 0.749, respectively. The sensitivity of APHE combined with Kupffer phase was significantly increased (χ²=11.58, P<0.05). Compared with the golden standard, the differences between the two diagnostic methods were statistically significant (P<0.05). Conclusion The combination of high arterial phase enhancement (APHE) and low vascular phase enhancement has a higher sensitivity for the diagnosis of HCC. The unique Kupffer phase of perfluorobutane may improve the detection rate of early HCC and provide more information in non-invasive diagnosis of HCC.

Key words: Hepatocellar carcinoma, Contrast-enhanced Ultrasound, Perfluorotane, LI-RADS, Non-invasive diagnosis

LIU Ting, YANG Jin-yu, LIU Qian-yu, YANY Qing. The value of perfluorobutane contrast-enhanced ultrasound for the diagnosis of hepatocellular carcinoma[J]. Chinese Hepatolgy, 2024, 29(4): 391-394.

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