title: Focal liver tumors: characterization with 3D perflubutane microbubble contrast agent-enhanced US versus 3D contrast-enhanced multidetector CT.
abstract: OBJECTIVE
  To investigate the potential application of contrast material-enhanced three-dimensional (3D) ultrasonography (US), as compared with contrast-enhanced 3D computed tomography (CT), for characterization of focal liver tumors.
  
  
  METHODS
  Institutional review board approval and informed patient consent were obtained. One hundred thirty-nine patients with focal liver tumors-77 hepatocellular carcinomas (HCCs), 33 metastases, 23 hemangiomas, and six focal nodular hyperplasias (FNHs)-who were examined at 3D US enhanced with a perflubutane microbubble contrast agent and at 3D contrast-enhanced multidetector CT were retrospectively identified. Two readers blindly reviewed the multiplanar images and angiograms reconstructed with both modalities and classified the depicted lesions according to diagnostic criteria based on their experience and published findings. Sensitivity, specificity, positive predictive value (PPV), area under the receiver operating characteristic curve (A(z)), intermodality agreement, and interreader agreement were assessed.
  
  
  RESULTS
  Readers 1 and 2 had concordant US and CT findings for 115 (83%) and 116 (83%) of the 139 lesions, respectively, with moderate to excellent (kappa = 0.55-0.81) intermodality agreement. There were no significant differences between the two modalities: Sensitivity was 83% or greater with both modalities, specificity was 87% or greater with contrast-enhanced US and 92% or greater with contrast-enhanced CT, the PPV was 71% or greater with both modalities, and the A(z) was at least 0.89 with US and at least 0.92 with CT. Interreader agreement was good to excellent (kappa > or = 0.76) with both modalities.
  
  
  CONCLUSIONS
  Contrast-enhanced 3D US potentially can be used to characterize focal liver tumors.
authors.affiliation: Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa 232-0024, Japan.
authors.forename: Wen
authors.initials: W
authors.lastname: Luo
authors.forename: Kazushi
authors.initials: K
authors.lastname: Numata
authors.forename: Manabu
authors.initials: M
authors.lastname: Morimoto
authors.forename: Masaaki
authors.initials: M
authors.lastname: Kondo
authors.forename: Shigeo
authors.initials: S
authors.lastname: Takebayashi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Okada
authors.forename: Satoshi
authors.initials: S
authors.lastname: Morita
authors.forename: Katsuaki
authors.initials: K
authors.lastname: Tanaka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D003287:Contrast Media; D005260:Female; D005466:Fluorocarbons; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D045423:Microbubbles; D008875:Middle Aged; D010363:Pattern Recognition, Automated / Q000379:methods*; D011856:Radiographic Image Enhancement / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*
chemical_list: D003287:Contrast Media; D005466:Fluorocarbons; C108042:perfluorobutane