title: [A comparative study of the hepatic transit time (HTT) of different ultrasound contrast agents in patients with liver metastases and healthy controls].
abstract: OBJECTIVE
  Liver metastases lead to a shortening of the HTT of an echo enhancer. Studies using SonoVue™ also showed a shortening of the HTT in healthy controls. Hence the HTT depends on the applied contrast agent. We examined whether the HTT of SonoVue™, Luminity™ und Levovist™ is useful to discriminate between patients with and without liver metastases.
  
  
  METHODS
  We compared the arteriovenous HTT of Levovist™, Sonovue™ und Luminity™ in 20 patients with liver metastases and in 15 controls. An Acuson Sequoia™ ultrasound system was used. The HTT results from the difference of the arrival time of the microbubbles in the hepatic artery and a hepatic vein.
  
  
  RESULTS
  Using Levovist™ six patients and three controls had to be excluded from further analysis. The arrival time was undetectable. The mean HTT values in healthy controls were: Levovsit™ 14.75 sec (SD ± 2.53 sec), SonoVue™ 9.27 sec (SD ± 2.41 sec) and Luminity™ 9.2 sec (SD ± 2.34 sec). In patients the mean HTT values were: Levovist™ 9.89 sec (SD ± 1.04 sec), SonoVue™ 6.28 sec (SD ± 2.41 sec) and Luminity™ 6.33 sec (SD ± 1.37 sec). Using a cut off of 8 sec for SonoVue™ and Luminity™, the sensitivity to exclude liver metastases was 75% and 80%.
  
  
  CONCLUSIONS
  The mean HTT values of all contrast agents were shorter in patients. Levovist™ showed a longer HTT in patients and controls than Luminity™ and SonoVue™. Levovist™ showed the best separation between patients and controls but some patients and controls had to be excluded. The HTT could still be a useful tool to exclude liver metastases but the HTT depends on the contrast agent and the applied contrast technique.
authors.affiliation: Medizinische Klinik 1, Universitätskliniken Erlangen. thomas.haendl@klinikumaugsburg.de
authors.forename: T
authors.initials: T
authors.lastname: Haendl
authors.forename: D
authors.initials: D
authors.lastname: Strobel
authors.forename: D
authors.initials: D
authors.lastname: Neureiter
authors.forename: K
authors.initials: K
authors.lastname: Esser
authors.forename: M
authors.initials: M
authors.lastname: Frieser
authors.forename: E G
authors.initials: EG
authors.lastname: Hahn
authors.forename: T
authors.initials: T
authors.lastname: Bernatik
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D005260:Female; D005466:Fluorocarbons / Q000493:pharmacokinetics*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008113:Liver Neoplasms / Q000097:blood* / Q000000981:diagnostic imaging*; D008297:Male; D008657:Metabolic Clearance Rate / Q000502:physiology; D008875:Middle Aged; D010743:Phospholipids / Q000493:pharmacokinetics*; D011134:Polysaccharides / Q000493:pharmacokinetics*; D012016:Reference Values; D013459:Sulfur Hexafluoride / Q000493:pharmacokinetics*; D014463:Ultrasonography / Q000379:methods*
chemical_list: D003287:Contrast Media; D005466:Fluorocarbons; D010743:Phospholipids; D011134:Polysaccharides; C420843:contrast agent BR1; C059891:SHU 508; C042852:perflutren; D013459:Sulfur Hexafluoride