Affiliations: [a] Department of Internal Medicine 1, University Hospital Erlangen, Friedrich-Alexander-UniversityErlangen-Nuremberg, Erlangen, Germany
| [b] Department of Medical Informatics, Biometry and Epidemiology (IMBE), Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
Correspondence:
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Corresponding author: Dane Wildner, Department of Internal Medicine 1, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Ulmenweg 18, 91054 Erlangen, Germany. Tel.: +49 9131 8535250; Fax: +49 9131 8535252; E-mail: dane.wildner@fau.de.
Note: [1] These authors contributed equally to this work.
Abstract: BACKGROUNDEnhancement patterns on contrast-enhanced ultrasound (CEUS) help to distinguish different liver tumors. OBJECTIVE:Assessing the diagnostic value of dynamic contrast-enhanced ultrasound (DCEUS) for the discrimination of different malignant liver lesions. METHODS:148 malignant focal liver lesions were assessed prospectively with DCEUS (hepatocellular carcinoma = HCC; cholangiocellular carcinoma = CCC; pancreatic adenocarcinoma = PCA; breast cancer = BC; colorectal cancer = CRC; melanoma = MM). Focal-nodular-hyperplasias (FNH) served as a reference for benign lesions. DCEUS-clips were recorded continuously over three minutes. DCEUS-values were compared between the tumor entities. For better inter-individual comparability, perfusion kinetics were analyzed considering the perfusion characteristics of the surrounding liver parenchyma (Relative Signal Intensity = RSI: lesion-liver tissue/liver tissue) at different points in time. RESULTS:Absolute signal intensity in FNH showed a tendency towards higher values compared with malignant liver lesions [Peak Enhancement(a.u.): FNH 7111.4; HCC 549.9; CCC −6654.3; PCA −7307.9; BC −4562.4; CRC −10672.9; MM −3034.1]. Washout was significantly less in FNH versus PCA and CRC, and more pronounced and earlier in PCA and CRC versus HCC [RSI 30 seconds after PE-lesion(%): FNH +52; PCA −65; CRC −76; HCC −26]. Rise Time, Fall Time and mean-Transit-Time did not differ significantly. CONCLUSIONS:DCEUS-values reflect significant differences between malignant liver lesions, especially at peak enhancement and during the washout phases.
