Document Detail

Indeterminate focal liver lesions incidentally discovered at gray-scale US: role of contrast-enhanced sonography.
MedLine Citation:
PMID:  20938345     Owner:  NLM     Status:  In-Process    
OBJECTIVES: to assess the role of contrast-enhanced ultrasound (CEUS) in the characterization of focal liver lesions (FLLs) incidentally discovered but indeterminate at gray-scale ultrasound (US).
MATERIALS AND METHODS: one hundred forty-two consecutive patients with 174 FLLs (169 benign and 5 malignant) incidentally discovered but indeterminate at gray-scale US, underwent CEUS after the administration of SonoVue. Two readers independently reviewed CEUS scans and: (1) classified each lesion as malignant or benign on a 5-point scale of confidence by means of definite diagnostic criteria; (2) provided if possible a specific diagnosis; (3) were requested if further imaging was needed for lesion characterization. Sensitivity, specificity, and areas under the receiver-operating characteristic curve (Az) as well as interobserver agreement were calculated.
RESULTS: at CEUS, both readers correctly differentiated benign from malignant lesions in 168 of 174 (96.5%) cases (P < 0.0001). A specific correct diagnosis was provided in 123 of 174 (70.7%) and 127 of 174 (72.9%) cases for reader 1 and 2, respectively (P < 0.0001). A further imaging study to characterize the lesion after CEUS was requested in 67 cases (38.5%) for reader 1 (P < 0.001) and 46 cases (26.4%) for reader 2 (P < 0.001). Receiver-operating characteristic analysis after CEUS revealed Az value of 1 for both readers and sensitivity and specificity values of 100% and 97.04% for reader 1 and 100% and 96.45 for reader 2 respectively (P < 0.0001). Inter-reader agreement at CEUS was good (weighted k = 0.779).
CONCLUSION: CEUS improves the diagnostic performance of radiologists in the characterization of indeterminate FLLs incidentally discovered at US and reduces the need for further radiologic work-up.
Tommaso Vincenzo Bartolotta; Adele Taibbi; Massimo Midiri; Domenica Matranga; Luigi Solbiati; Roberto Lagalla
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Investigative radiology     Volume:  46     ISSN:  1536-0210     ISO Abbreviation:  Invest Radiol     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0045377     Medline TA:  Invest Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  106-15     Citation Subset:  IM    
Department of Radiology, University of Palermo, Palermo, Italy; and †Department of Radiology, General Hospital, Busto Arsizio Varese, Italy.
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