Ultraschall Med 2021; 42(02): 120-124
DOI: 10.1055/a-1347-1388

Using contrast-enhanced ultrasound in the diagnosis of hepatocellular carcinoma – what we have and have not achieved

Kontrastmittelsonografie in der Diagnostik des hepatozellulären Karzinoms – was wir erreicht haben und was nicht
Deike Strobel

The initial applications of contrast-enhanced ultrasound to the diagnosis of liver tumors were employed more than 30 years ago in Germany. Initially intended for enhanced imaging of liver metastases, contrast-enhanced ultrasonography evolved into an ideal technique for characterizing focal liver lesions. The introduction of stable contrast agents (SonoVue) and low-MI imaging technology in 2001 marked the breakthrough for widespread clinical use in Europe. Important pioneering work by individual research groups on contrast-enhanced sonographic tumor vascularization patterns was followed in 2008 by the first prospective DEGUM multicenter study with 1349 patients, which demonstrated a greater than 90 % diagnostic accuracy of contrast-enhanced sonography when differentiating B-scan-morphologically unclear hepatic lesions compared to histologically-verified masses [1] [2] [3]. Numerous European multicenter studies have confirmed the high diagnostic value of contrast-enhanced ultrasonography, also in comparison to CT and MRI [4] [5] [6] [7]. Meta-analyses followed, including that of M. Friedrich-Rust in 2013, which demonstrated excellent diagnostic accuracy of contrast-enhanced sonography in differentiating benign and malignant liver lesions in 7231 focal liver lesions, with a sensitivity of 93 % (range 91–95 %) and a specificity of 90 % (range 88–93 %) [8]. The high value of contrast-enhanced sonography was shown when compared to MRT and CT, and also with respect to small hepatic lesions as a problem solver in focal findings which due to their tiny size cannot be classified with certainty using CT or MRI [9]. Contrast-enhanced sonography rightly occupies a firm position in liver tumor diagnostics [10] [11]. It is a cost-effective method, safe to use, and for many patients shortens the path through diagnostic processes [12] [13].

Publication History

Publication Date:
12 April 2021 (online)

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