Diagnostic performance of contrast-enhanced ultrasound for complex cystic focal liver lesions: blinded reader study.
The study was aimed at evaluating the diagnostic performance of contrast-enhanced ultrasound (CEUS) in characterizing complex cystic focal liver lesions (FLLs). Sixty-seven complex cystic FLLs in 65 patients were examined with conventional ultrasound (US) and real-time CEUS. The US and CEUS images were reviewed by a resident radiologist and a staff radiologist independently. Receiver operating characteristic (ROC) analysis was performed to evaluate the diagnostic performance, and the interobserver agreement was analysed. The results showed that complete non-enhancement throughout three phases of CEUS or sustained enhancement in the portal and late phases were exhibited in most benign lesions. Conversely, hypo-enhancement in the late phase was seen in all malignancies. After ROC analysis, the areas (Az) under the ROC curve were 0.774 at US versus 0.922 at CEUS (P=0.047) by the resident radiologist, and 0.917 versus 0.935 (P=0.38) by the staff radiologist. A significant difference in Az between the resident and the staff radiologists was found for US (0.774 versus 0.917, P=0.044), whereas not found for CEUS (0.922 versus 0.935, P=0.42). Interobserver agreement was improved after CEUS (kappa=0.325 at US versus kappa=0.774 at CEUS). Real-time CEUS improves the capability of discrimination between benign and malignant complex cystic FLLs, especially for the resident radiologist.
Lin
Man-Xia
MX
Department of Medical Ultrasonics, The First Affiliated Hospital, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, China.
Xu
Hui-Xiong
HX
Lu
Ming-De
MD
Xie
Xiao-Yan
XY
Chen
Li-Da
LD
Xu
Zuo-Feng
ZF
Liu
Guang-Jian
GJ
Xie
Xiao-Hua
XH
Liang
Jin-Yu
JY
Wang
Zhu
Z
D000293:Adolescent; D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008107:Liver Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012372:ROC Curve; D011871:Radiology / Q000379:methods*; D015203:Reproducibility of Results; D014463:Ultrasonography / Q000379:methods*
D003287:Contrast Media
Br J Radiol. 2001 Mar;74(879):270-2
11338106
J Gastroenterol. 2003;38(2):190-3
12640536
Radiology. 2004 Aug;232(2):420-30
15286314
Ultraschall Med. 2008 Feb;29(1):28-44
18270887
J Ultrasound Med. 2006 Mar;25(3):349-61
16495496
AJR Am J Roentgenol. 2004 Feb;182(2):447-50
14736679
Radiographics. 2001 Jul-Aug;21(4):895-910
11452064
World J Surg. 2006 Aug;30(8):1560-6
16865321
J Ultrasound Med. 2008 Feb;27(2):243-54
18204015
J Radiol. 1998 May;79(5):409-14
9757269
Ir J Med Sci. 2001 Oct-Dec;170(4):251-3
11918332
AJR Am J Roentgenol. 1981 Feb;136(2):345-8
6258409
AJR Am J Roentgenol. 1989 Sep;153(3):507-11
2669463
AJR Am J Roentgenol. 1978 Aug;131(2):235-8
98001
World J Surg. 2002 Apr;26(4):462-9
11910481
J Ultrasound Med. 2006 Jan;25(1):23-33
16371552