title: Standardize and compare contrast-enhanced ultrasonographic digital images obtained with different technologies: how to overcome the subjectivity.
abstract: OBJECTIVE
  This study was conducted to compare digital images obtained with cadence contrast pulse sequencing (CPS) and coherent contrast imaging (CCI) technologies for contrast-enhanced ultrasonography (CEUS).
  
  
  METHODS
  A CEUS study on 17 focal liver lesions was performed using CPS and CCI technologies with a second-generation contrast media. The lesion/liver ratio and conspicuity index were then calculated and compared with Adobe Photoshop 6.0.
  
  
  RESULTS
  Lesion/liver ratio and conspicuity index using CCI ranged from 1.3 to 7.1 (mean value, 3) and 19 to 127 (mean value, 58), respectively; by using CPS, we obtained results ranging from 2 to 19.1 (mean value, 8.9) and 57 to 164 (mean value, 109.2). Lesion/liver ratio and the conspicuity index for the lesions using CPS showed significantly (p < 0.0001) superior results than those obtained using CCI.
  
  
  CONCLUSIONS
  The computed analysis with standardization allows an objective evaluation of digital images of CEUS. CPS technology resulted in better lesion conspicuity compared to CCI during CEUS study on focal liver lesions.
authors.affiliation: Department of Radiology, Policlinico G.B. Rossi, University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy. mirko.donofrio@univr.it
authors.forename: Mirko
authors.initials: M
authors.lastname: D'Onofrio
authors.forename: Niccolò
authors.initials: N
authors.lastname: Faccioli
authors.forename: Roberto
authors.initials: R
authors.lastname: Malagò
authors.forename: Giulia
authors.initials: G
authors.lastname: Zamboni
authors.forename: Roberto Pozzi
authors.initials: RP
authors.lastname: Mucelli
mesh_terms: D003287:Contrast Media; D003937:Diagnosis, Differential; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008107:Liver Diseases / Q000000981:diagnostic imaging*; D015588:Observer Variation; D010743:Phospholipids; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric; D013459:Sulfur Hexafluoride; D014463:Ultrasonography / Q000379:methods* / Q000592:standards*
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride