title: Utility of contrast-enhanced ultrasound with perflubutane for diagnosing the macroscopic type of small nodular hepatocellular carcinomas.
abstract: OBJECTIVE
  To clarify the diagnostic value of contrast-enhanced ultrasound (CEUS) with perflubutane in the macroscopic classification of small nodular hepatocellular carcinomas (HCCs).
  
  
  METHODS
  A total of 99 surgically resected nodular HCCs with a maximum diameter of 3 cm or less were analysed. HCCs were macroscopically categorized as simple nodular (SN) and non-SN. CEUS findings were evaluated during the arterial phase (vascularity, level and shape of enhancement), portal phase (presence or absence of washout) and post-vascular phase (echo intensity and shape).
  
  
  RESULTS
  Sixty-eight HCCs were categorized as SN and the remaining 31 were categorized as non-SN. For diagnosis of non-SN HCC, the areas under the receiver operating characteristic curve (A z) value for the shape of enhancement in the late arterial phase and the shape of the post-vascular image were 0.824 (95 % confidence interval [CI] 0.721-0.895) and 0.878 (95 % CI 0.788-0.933), respectively. The A z value for the combination of the shape of enhancement in the late arterial phase and the shape of the post-vascular image for the diagnosis of non-SN HCC was 0.907 (95 % CI 0.815-0.956), corresponding to a high diagnostic value.
  
  
  CONCLUSIONS
  CEUS can provide high-quality imaging assessment for determining the macroscopic classification of small nodular HCCs.
  
  
  CONCLUSIONS
  • Non-SN is one of the poor prognostic factors in patients with HCC • Assessment of macroscopic type provides valuable information for the management of HCC • CEUS can provide high-quality imaging assessment for macroscopic classification of HCC • For non-SN HCC diagnosed using CEUS, hepatectomy is preferred as curative treatment.
authors: Ogaki Municipal Hospital, Ogaki, Japan, tadat0627@gmail.com.
authors: Toshifumi
authors: T
authors: Tada
authors: Takashi
authors: T
authors: Kumada
authors: Hidenori
authors: H
authors: Toyoda
authors: Takanori
authors: T
authors: Ito
authors: Yasuhiro
authors: Y
authors: Sone
authors: Yuji
authors: Y
authors: Kaneoka
authors: Atsuyuki
authors: A
authors: Maeda
authors: Seiji
authors: S
authors: Okuda
authors: Katsuhiko
authors: K
authors: Otobe
authors: Kenichi
authors: K
authors: Takahashi
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D005260:Female; D005466:Fluorocarbons; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008297:Male; D012372:ROC Curve; D012189:Retrospective Studies; D014463:Ultrasonography
chemical_list: D005466:Fluorocarbons; C108042:perfluorobutane