title: Contrast enhanced ultrasound in the detection of liver metastases: a prospective multi-centre dose testing study using a perfluorobutane microbubble contrast agent (NC100100).
abstract: OBJECTIVE
  To conduct a dose testing analysis of perfluorobutane microbubble (NC100100) contrast-enhanced ultrasound (CEUS) to determine the optimal dose for detection of liver metastases in patients with extra-hepatic primary malignancy.
  
  
  METHODS
  157 patients were investigated with conventional US and CEUS. CEUS was performed following intravenous administration of perfluorobutane microbubbles (using one dose of either 0.008, 0.08, 0.12 or 0.36 μL/kg body weight). Three blinded off-site readers recorded the number and locations of metastatic lesions detected by US and CEUS. Contrast enhanced CT and MRI were used as the "Standard Of Reference" (SOR). Sensitivity, specificity and accuracy of liver metastasis detection with US versus CEUS, for each dose group were obtained. Dose group analysis was performed using the Chi-square test.
  
  
  RESULTS
  165 metastases were present in 92 patients who each had 1-7 lesions present on the SOR. Sensitivity of US versus CEUS (for all doses combined) was 38% and 67% (p = 0.0001). The 0.12 dose group with CEUS (78%) had significantly higher sensitivity and accuracy (70%) compared to other dose groups (p < 0.05).
  
  
  CONCLUSIONS
  The diagnostic performance of CEUS is dose dependent with the 0.12 μL/kg NC100100 dose group showing the greatest sensitivity and accuracy in detection of liver metastases.
authors.affiliation: Department of Adult Radiology, Groupe Hospitalier Necker Enfants-Malades, Paris, France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Correas
authors.forename: Gavin
authors.initials: G
authors.lastname: Low
authors.forename: Laurence
authors.initials: L
authors.lastname: Needleman
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Robbin
authors.forename: David
authors.initials: D
authors.lastname: Cosgrove
authors.forename: Paul S
authors.initials: PS
authors.lastname: Sidhu
authors.forename: Chris J
authors.initials: CJ
authors.lastname: Harvey
authors.forename: Thomas
authors.initials: T
authors.lastname: Albrecht
authors.forename: Jarl A
authors.initials: JA
authors.lastname: Jakobsen
authors.forename: Knut
authors.initials: K
authors.lastname: Brabrand
authors.forename: Manfred
authors.initials: M
authors.lastname: Jenett
authors.forename: Jane
authors.initials: J
authors.lastname: Bates
authors.forename: Michel
authors.initials: M
authors.lastname: Claudon
authors.forename: Edward
authors.initials: E
authors.lastname: Leen
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D005290:Ferric Compounds / Q000008:administration & dosage*; D006801:Humans; D007501:Iron / Q000008:administration & dosage*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D008279:Magnetic Resonance Imaging; D008297:Male; D045423:Microbubbles; D008875:Middle Aged; D010087:Oxides / Q000008:administration & dosage*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D003287:Contrast Media; D005290:Ferric Compounds; D010087:Oxides; C069727:Sonazoid; D007501:Iron