title: Diagnostic performance of contrast-enhanced ultrasound for complex cystic focal liver lesions: blinded reader study.
abstract: 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.
authors.affiliation: 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.
authors.forename: Man-Xia
authors.initials: MX
authors.lastname: Lin
authors.forename: Hui-Xiong
authors.initials: HX
authors.lastname: Xu
authors.forename: Ming-De
authors.initials: MD
authors.lastname: Lu
authors.forename: Xiao-Yan
authors.initials: XY
authors.lastname: Xie
authors.forename: Li-Da
authors.initials: LD
authors.lastname: Chen
authors.forename: Zuo-Feng
authors.initials: ZF
authors.lastname: Xu
authors.forename: Guang-Jian
authors.initials: GJ
authors.lastname: Liu
authors.forename: Xiao-Hua
authors.initials: XH
authors.lastname: Xie
authors.forename: Jin-Yu
authors.initials: JY
authors.lastname: Liang
authors.forename: Zhu
authors.initials: Z
authors.lastname: Wang
mesh_terms: 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*
chemical_list: D003287:Contrast Media
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