Differentiation between malignant and benign nodules in the liver: use of contrast C3-MODE technology.
OBJECTIVE
To investigate the value of contrast-enhanced C3-MODE technology in differentiating malignant nodules of liver from the benign ones.


METHODS
Forty-six nodules in 36 patients (29 men and 7 women) were studied by contrast-enhanced C3-MODE technology and contrast-enhanced CT in 1 wk before the biopsy or operation. A low MI monitor and a high MI flash imaging were intermittently performed. After the injection of contrast agent, the period from 10 to 30 s and the time later than 100 s were respectively defined as early arterial phase and the late phase. The vascularities of the liver nodules in the two phases were combined for differential diagnosis. Corresponding to the pathological diagnosis, the accuracy, sensitivity and specificity of contrast-enhanced C3-MODE technology were compared to those of contrast-enhanced CT.


RESULTS
By C3-MODE technology, 33 of the 46 liver nodules were demonstrated as defected area in the late phase and were diagnosed as malignant tumors. Of them, 28 with hypervascularity in the early arterial phase were assessed as hepatocellular carcinoma, the other five nodules with rim-like enhancement in the early arterial phase were diagnosed as metastatic tumors. Thirteen nodules were shown as iso or hypervascularity in the late phase as well as centripetal filling in the early arterial phase and we made a diagnosis of hemangioma. Corresponding to the pathological results, the sensitivity, specificity and accuracy of contrast-enhanced C3-MODE technology in differentiating malignant and benign nodules in the liver were 97.0%, 92.3% and 95.7%, respectively. With comparison to those of contrast CT (sensitivity, 94.1%; specificity, 91.7%; accuracy, 93.5%), the difference was not significant.


CONCLUSIONS
Contrast-enhanced C3-MODE technology can effectively differentiate malignant liver tumors from the benign nodules. It highly agrees diagnostically with the pathology. We suggest that it provides a new approach for differential diagnosis of liver nodules in addition to contrast-enhanced CT.
Luo
Bao-Ming
BM
Department of Ultrasound, the Second Affiliated Hospital, Sun Yat-Sen University, 107 Yanjiangxi Rd, Guangzhou 510120, Guangdong Province, China.
Wen
Yan-Ling
YL
Yang
Hai-Yun
HY
Zhi
Hui
H
Ou
Bing
B
Ma
Jian-Hong
JH
Pan
Jing-Sheng
JS
Dai
Xiao-Ning
XN
D000230:Adenocarcinoma / Q000473:pathology / Q000648:ultrastructure; D000328:Adult; D000368:Aged; D001706:Biopsy; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000648:ultrastructure*; D003287:Contrast Media; D003937:Diagnosis, Differential; D005234:Fatty Liver / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006391:Hemangioma / Q000000981:diagnostic imaging / Q000473:pathology; D006509:Hepatitis B / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*
D003287:Contrast Media