Semiquantitative characterization of hepatocellular carcinoma (HCC)--perfusion with contrast-enhanced ultrasound and perfusion analysis.
BACKGROUND
At the moment, there is only poor specificity of HCC-detection in tumors smaller than 2 cm in a cirrhotic liver. Thus, efforts have to be made to optimize the distinction between regenerative nodules and HCC.


OBJECTIVE
The aim of our study was to describe the particular perfusion pattern of hepatocellular carcinoma using a specific quantification software.


METHODS
We evaluated 25 patients with proven hepatocellular carcinoma, who underwent dynamic contrast-enhanced ultrasound (CEUS) using a second generation contrast agent (SonoVue, Bracco, Germany). Retrospectively, we applied the quantification software Qontrast (Bracco, Milan, Italy) to obtain contrast-enhanced sonographic perfusion maps for each lesion.


RESULTS
We found a close positive correlation of the perfusion parameters peak, time-to-peak and regional blood volume between the entire tumors, the center (center/total) and the periphery of the tumors (periphery/total), respectively. Moreover, we found significant higher peak values, a significant higher regional blood volume and a trend to lower time-to-peak in the center of the tumors compared to the tumor periphery.


CONCLUSIONS
These results suggest a better established vascular bed in the center of the tumors. This could be a sonographic marker of HCC in contrast to regenerative nodules.
Schacherer
D
D
Department of Internal Medicine I, Interdisciplinary Center of Clinical Ultrasound, University of Regensburg, Regensburg, Germany.
Girlich
C
C
Wiest
R
R
Büttner
R
R
Schölmerich
J
J
Feuerbach
S
S
Zorger
N
N
Hamer
O W
OW
Jung
E M
EM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology / Q000473:pathology; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010477:Perfusion / Q000379:methods; D010743:Phospholipids / Q000008:administration & dosage; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D014463:Ultrasonography; D000509:alpha-Fetoproteins / Q000378:metabolism
D003287:Contrast Media; D010743:Phospholipids; D000509:alpha-Fetoproteins; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride