Contrast-enhanced ultrasound improves diagnosis in some liver cancer cases

Injected contrast improved liver ultrasound sensitivity and specificity in malignant liver lesions, aiding diagnosis in 13.7% of cases in a French study. Researchers concluded that contrast-enhanced ultrasound should be routine practice when considering surgical management of hepatic lesions.

Dr. Linda Chami and colleagues at the Institut Gustave Roussy in Villejuif examined 116 patients, first with conventional ultrasound, then with contrast-enhanced ultrasound combined with perfusion software - either vascular recognition or pulse subtraction imaging. Histological results served as the standard for judging sensitivity and specificity for both exams.

The researchers published their study in the March issue of the American Journal of Roentgenology.

Of the 116 patients, 82 were treated surgically, 31 didn't qualify for surgery because of disseminated lesions, and three didn't meet the study's inclusion criteria. Surgery identified 306 hepatic lesions, and histopathologic analysis showed 233 were malignant and 73 benign.

Baseline sonography detected a total of 147 lesions, while contrast-enhanced sonography detected 177. When compared with the histological results, contrast-enhanced sonography detected 23 more malignant lesions than did the baseline exam. These had been identified as lacunae at the portal venous phase and benign nodules on baseline sonography.

The researchers found that contrast-enhanced ultrasound had a sensitivity of 68.7% and specificity of 67%, while baseline ultrasound had a sensitivity of 58.8% and specificity of 50.7%.

Injected contrast improved liver ultrasound exam results in 13.7% of cases. The researchers concluded that it should become part of routine assessment of hepatic lesions prior to surgery.