Contrast-enhanced ultrasound shows vascular details of liver nodules

Contrast-enhanced ultrasound with microflow imaging provides noninvasive analysis of the vascular structure and hemodynamics of liver nodules. This analysis, in turn, provides information about how advanced hepatocellular carcinoma is.

Dr. Katsutoshi Sugimoto and colleagues in the gastroenterology and hepatology department at Tokyo Medical University, along with Toshiba and Hyogo College of Medicine in Hyogo, Japan, studied a total of 61 liver nodules with contrast-enhanced ultrasound using microflow imaging. They were able to see the blood vessels down to the fine branches.

Two independent readers classified each nodule according to its vascular framework as having a normal, cotton, vascular, or deadwood pattern. The researchers then compared these results with the histological diagnoses of the nodules.

Of the 61 total nodules, 20 were well-differentiated, 26 were moderately differentiated, and 15 were poorly differentiated hepatocellular carcinomas.

A poorly differentiated vascular structure in hepatocellular carcinoma correlates with advanced cancer, usually metastasized to distant sites.

The researchers published their findings in Hepatology Research, which made it available online May 27.

They found that normal and cotton ultrasound patterns were associated with well-differentiated hepatocellular carcinoma, while the vascular pattern was associated with moderately differentiated nodules, and the deadwood pattern was associated with poorly differentiated hepatocellular carcinomas.

Using these criteria, assessments by reader one showed an 85% sensitivity, 92.7% specificity, and 90% accuracy. Assessments by reader two showed an 85% sensitivity, 82.9% specificity, and 83.6% accuracy.

The researchers concluded that contrast-enhanced ultrasound with microflow imaging could be used to get an accurate view of the vascular structure of hepatocellular carcinoma.