title: Semiquantitative characterization of hepatocellular carcinoma (HCC)--perfusion with contrast-enhanced ultrasound and perfusion analysis.
abstract: 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.
authors.affiliation: Department of Internal Medicine I, Interdisciplinary Center of Clinical Ultrasound, University of Regensburg, Regensburg, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Schacherer
authors.forename: C
authors.initials: C
authors.lastname: Girlich
authors.forename: R
authors.initials: R
authors.lastname: Wiest
authors.forename: R
authors.initials: R
authors.lastname: Büttner
authors.forename: J
authors.initials: J
authors.lastname: Schölmerich
authors.forename: S
authors.initials: S
authors.lastname: Feuerbach
authors.forename: N
authors.initials: N
authors.lastname: Zorger
authors.forename: O W
authors.initials: OW
authors.lastname: Hamer
authors.forename: E M
authors.initials: EM
authors.lastname: Jung
mesh_terms: 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
chemical_list: D003287:Contrast Media; D010743:Phospholipids; D000509:alpha-Fetoproteins; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride