title: Focal liver lesions: can SonoVue-enhanced ultrasound be used to differentiate malignant from benign lesions?
abstract: OBJECTIVE
  To evaluate whether contrast-enhanced ultrasound (CEUS) with SonoVue could differentiate malignant focal liver lesions (FLLs) from benign lesions and provide lesion type diagnoses.
  
  
  METHODS
  Four hundred fifty-six patients with 554 FLLs were examined by CEUS with SonoVue using low mechanical index, nonlinear imaging techniques. Each lesion was characterized by 2 independent off-site readers as malignant or benign and given specific lesion type diagnosis, if possible, both at baseline ultrasound (US) and after SonoVue administration (CEUS). The final diagnosis was achieved by histopathology obtained from biopsy or surgical specimens, or by typical manifestation on contrast-enhanced CT or MRI.
  
  
  RESULTS
  The diagnostic accuracies of the 2 readers were 41.9% and 35.2% for baseline US, which improved significantly to 87.2% and 87.9% for CEUS (P < 0.05). Interreader agreement also increased with CEUS compared with baseline US (ê value changed from 0.49 to 0.77). The accuracy for lesion type diagnosis was 38.4% and 32.5% for baseline US, which increased to 77.6% and 78.0% for CEUS (P < 0.05).
  
  
  CONCLUSIONS
  CEUS with SonoVue improves differentiation between malignant and benign FLLs, and also provides improved lesion type (differential) diagnosis.
authors.affiliation: Department of Ultrasound, School of Oncology, Peking University, Beijing, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Dai
authors.forename: Min Hua
authors.initials: MH
authors.lastname: Chen
authors.forename: Shan Shan
authors.initials: SS
authors.lastname: Yin
authors.forename: Kun
authors.initials: K
authors.lastname: Yan
authors.forename: Zhi Hui
authors.initials: ZH
authors.lastname: Fan
authors.forename: Wei
authors.initials: W
authors.lastname: Wu
authors.forename: Yan Bin
authors.initials: YB
authors.lastname: Wang
authors.forename: Wei
authors.initials: W
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology*; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000556:secondary; D008297:Male; D045423:Microbubbles; D008875:Middle Aged; D015588:Observer Variation; D012015:Reference Standards; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*
chemical_list: D003287:Contrast Media