Do different types of liver lesions differ in their uptake of the microbubble contrast agent SH U 508A in the late liver phase? Early experience.
OBJECTIVE
To compare the uptake of SH U 508A in different types of liver lesions by using stimulated acoustic emission.


METHODS
Thirty-seven patients with characterized lesions (metastasis, n = 17; hepatocellular carcinoma, n = 4; hemangioma, n = 9; focal nodular hyperplasia, n = 7) received 2.5 g SH U 508A. After 5 minutes, stimulated acoustic emission was elicited by using a previously described method. Liver and/or lesional differences were assessed with videodensitometry (objective conspicuity score), and two observers assessed each lesion by using a six-point scale (subjective conspicuity score).


RESULTS
Metastases and hepatocellular carcinoma had low stimulated acoustic emission; median objective conspicuity scores were 70% and 68% (all scores were > or =43%), respectively, and subjective conspicuity scores were 2 or higher for both observers. Hemangiomas had reduced stimulated acoustic emission, with more variability; the median objective conspicuity score was 41% (range, 9%-72%), and the median subjective conspicuity scores were 2 (range, 1-4) and 3.5 (range, 1-5) for observers 1 and 2, respectively. Focal nodular hyperplasia had stimulated acoustic emission comparable to that of the liver in all cases; the median objective conspicuity score was -4.7% (all scores were <6%), and the subjective conspicuity score was 1 or lower for both observers. This finding completely separated focal nodular hyperplasia and malignancies. Significant differences were seen between focal nodular hyperplasia and all other lesion types (P < .05).


CONCLUSIONS
Strong late-phase lesional uptake of SH U 508A is characteristic of focal nodular hyperplasia, is seen in some hemangiomas, and was not observed in malignancies.
Blomley
M J
MJ
Dept of Imaging, Hammersmith Hospital, Imperial College School of Medicine, 150 du Cane Rd, London W12 0HS, England. m.blomley@ic.ac.uk
Sidhu
P S
PS
Cosgrove
D O
DO
Albrecht
T
T
Harvey
C J
CJ
Heckemann
R A
RA
Butler-Barnes
J
J
Eckersley
R J
RJ
Basilico
R
R
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000378:metabolism; D003287:Contrast Media / Q000493:pharmacokinetics*; D005260:Female; D020518:Focal Nodular Hyperplasia; D006391:Hemangioma / Q000378:metabolism; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000378:metabolism; D008113:Liver Neoplasms / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011134:Polysaccharides / Q000493:pharmacokinetics*; D014463:Ultrasonography
D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508