Preliminary experience of a new perspective view technology for the detection of portal vein thrombus in hepatocellular carcinoma patients.
OBJECTIVE
To assess the feasibility and efficiency of a perspective view technology (Fly Thru) for the detection of portal vein tumor thrombus (PVTT) in hepatocellular carcinoma (HCC) patients.


METHODS
Fly Thru was performed in 79 HCC patients. The images were reviewed off-site for evaluation of the imaging quality and diagnosis. Pathology and/or contrast-enhanced CT was used as the reference standard for PVTT. The diagnostic quality of the images, presences of PVTT, and patency of the target vessels were recorded by two-dimensional ultrasound (2DUS) and Fly Thru image. The diagnostic performances of resident and staff radiologists were compared between 2DUS with or without off-line Fly Thru.


RESULTS
Fly Thru was performed successfully in 43 of 79 patients (54.4%). The Fly Thru Imaging quality was good in 30/43 patients (69.8%), suboptimal but diagnostic in 10/43 (23.2%), and non-diagnostic in the remaining 3/43 (7.0%). PVTTs were detected in 31 patients according to the reference standard, with 8 in the main portal vein, 15 in the first branch, and 8 in the second branch of the portal vein. The agreement was good between conventional 2DUS and Fly Thru (κ = 0.783, p = 0.000). There was a significant association between the quality and the ability of Fly Thru in the detection of PVTTs (p = 0.001). The diagnostic performance for both readers between 2DUS with or without Fly Thru showed no statistically significant differences, except for the sensitivity for resident radiologist. The sensitivity of 2DUS (71.0%, 22/31) for resident radiologists was lower than that of Fly Thru as an adjunctive diagnostic tool (90.3%, 28/31) (p = 0.041).


CONCLUSIONS
Fly Thru is of diagnostic quality and can provide useful information for the detection of PVTT in HCC patients.
Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, No. 58 Zhongshan Road 2, Guangzhou, 510080, People's Republic of China.
Wei
W
Wang
Guang-Jian
GJ
Liu
Li-Da
LD
Chen
Zhu
Z
Wang
Lu-Yao
LY
Zhou
Ming-De
MD
Lu
Xiao-Yan
XY
Xie
Yang
Y
Huang
Wei
W
Li
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008113:Liver Neoplasms / Q000150:complications*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011169:Portal Vein / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000150:complications* / Q000000981:diagnostic imaging*