title: Dynamic contrast-enhanced ultrasound (DCE-US) for easy and rapid evaluation of hepatocellular carcinoma compared to dynamic contrast-enhanced computed tomography (DCE-CT)--a pilot study.
abstract: OBJECTIVE
  To check the feasibility of the easy quantification of tumor vascularization derived from dynamic contrast-enhanced ultrasound (DCE-US) in comparison to dynamic contrast-enhanced computed tomography (DCE-CT) in patients with hepatocellular carcinoma (HCC).
  
  
  METHODS
  19 patients with cirrhosis and histologically proven HCC prospectively underwent CEUS (SonoVue) and CT (Imeron400). Following CEUS, the software ImageJ was used for the easy quantification of the echogenicity in HCC lesions and tumor-free liver parenchyma. For DCE-CT we used the software Hepacare and created arterial enhancement fraction color maps of the whole liver and HCC lesions.
  
  
  RESULTS
  Unifocal/multifocal HCCs were detected in 12/7 (US) and 10/9 patients (CT) and biopsied nodules were defined as a reference lesion with a median of 40 mm (US) and 42 mm (CT). CEUS showed HCC-typical hyper-/hypoenhancement in the arterial/late phase in 16/19 reference lesions, while all reference lesions showed an HCC-typical vascular pattern in CT. With DCE-US, quantitative assessment could not be performed in 3/19 patients due to respiratory motion or insufficient image quality. 13/16 reference lesions showed an HCC-typical vascular pattern. Quantitative assessment was possible with DCE-CT in all patients and all reference nodules showed HCC-typical values of the arterial enhancement fraction. There was no statistical difference between CEUS, DCE-US and DCE-CT in the quantitative assessment of contrast enhancement.
  
  
  CONCLUSIONS
  The quantitative evaluation of DCE-US was feasible in HCC without a statistical difference with respect to DCE-CT. Further studies with a larger study population including small nodules ≤ 2 cm are needed to assess whether this technique is helpful in routine ultrasound.
authors.affiliation: Departement of Internal Medecine 1, University of Erlangen, Germany. Cornelia.Egger@uk-erlangen.de
authors.forename: C
authors.initials: C
authors.lastname: Egger
authors.forename: R S
authors.initials: RS
authors.lastname: Goertz
authors.forename: D
authors.initials: D
authors.lastname: Strobel
authors.forename: M
authors.initials: M
authors.lastname: Lell
authors.forename: M F
authors.initials: MF
authors.lastname: Neurath
authors.forename: F
authors.initials: F
authors.lastname: Knieling
authors.forename: M
authors.initials: M
authors.lastname: Scharf
mesh_terms: D000368:Aged; D001707:Biopsy, Needle; D006528:Carcinoma, Hepatocellular / Q000098:blood supply* / Q000175:diagnosis*; D002983:Clinical Competence; D003287:Contrast Media / Q000008:administration & dosage*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007505:Iron-Dextran Complex; D008113:Liver Neoplasms / Q000098:blood supply* / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000175:diagnosis*; D010743:Phospholipids; D010865:Pilot Projects; D012680:Sensitivity and Specificity; D013459:Sulfur Hexafluoride; D013673:Technology Assessment, Biomedical; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014463:Ultrasonography / Q000379:methods*; D018084:Ultrasonography, Interventional
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D007505:Iron-Dextran Complex; D013459:Sulfur Hexafluoride