• Asian Pacific Journal of Cancer Prevention
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• 제13권2호
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• pp.493-497
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• 2012

This study was conducted to retrospectively evaluate the pattern of contrast enhancement with SonoVue on gray-scale ultrasonography of hepatic angiomyolipoma (HAML). Imaging features of 33 pathologically proven HAML lesions in 33 patients who underwent baseline ultrasound and contrast-enhanced ultrasonography (CEUS) were assessed retrospectively. All lesions were enhanced in the arterial phase and showed whole-tumor filling in. Thirty-two of 33 (97%) lesions showed early positive enhancement in the arterial phase. Twenty-three of these exhibited isoechoic or hyperechoic features in the portal phase. HAML demonstrate characteristic manifestations with SonoVue-enhanced real-time gray-scale ultrasonography.

• Clinical Pain
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• 제20권2호
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• pp.86-92
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• 2021

Ultrasound imaging in clinical practice is one of the widely used diagnostic methods because there is no radiation risk, more cost- effective compared to MRI or CT, and possible to perform an intervention through fast real-time imaging. In order to increase the diagnostic value, the studies of contrast-enhanced ultrasound (CEUS) using an ultrasound contrast agent have been actively conducted since about 50 years ago and are being used clinically in vascularity and microcirculation of internal organs. Although ultrasound is actively used for the diagnosis and treatment of various diseases in musculoskeletal disorders, there are some limitations in diagnosing mild or small lesions, inflammatory reactions, or abnormalities at the molecular level. In this review, the principles, types, and research, and clinical applications of ultrasound contrast agents have been summarized and introduced. If we understand the characteristics of the ultrasound contrast agents and anatomical knowledge, as well as molecular changes, the ultrasound contrast agents are widely applied in musculoskeletal disorders and have tremendous potential for diagnosis and treatment.

• Asian Pacific Journal of Cancer Prevention
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• 제15권17호
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• pp.7449-7452
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• 2014

Background: The purpose of this study was to investigate the correlation of contrast-enhanced ultrasonographic (CEUS) features with microvessel density (MVD) in papillary thyroid carcinomas (PTCs). Materials and Methods: Contrast-enhanced ultrasonography (CEUS) was performed in 62 patients (17 men and 45 women) with PTC. Tomtec software was applied to analyze the time intensity curve of CEUS. Immunohistochemistry was performed to evaluate the level of MVD in papillary thyroid carcinoma. Then the relationship between quantitative feature and the level of MVD was analyzed using SPSS 16.0 software. Results: The mean peak intensity of PTC tissues was lower than that of peripheral thyroid parenchyma ($61.9{\pm}11.8%$ vs 100%, p<0.05). The MVDs of CD34 and CD31 antibodies staining were $38.0{\pm}6.1$ and $37.9{\pm}5.1$ respectively in 62 PTC samples. A significantly positive correlation was observed between peak intensity and MVD in PTC tissues ($P_{CD34}$<0.01, $r_{CD34}$=0.838, $P_{CD31}$<0.01, $r_{CD31}$=0.837). Conclusions: The peak intensity in CEUS could reflect the MVD in PTC tissues. Therefore, quantification of CEUS seems to be helpful for assessment of MVD in PTC tissues.

• 정보처리학회논문지:소프트웨어 및 데이터공학
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• 제9권2호
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• pp.69-76
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• 2020

본 연구에서는 조영증강 초음파 영상에서 조영효과 확산 패턴과 동적 혈류 패턴을 가시화 하는 방법론을 제시한다. 세부적으로 조영증강 초음파 데이터에서 조영제의 전이시간, 최대 명도변화, 조영효과의 감쇄 시간 등과 같은 진단 파라미터를 영상으로 생성하는 기법을 제안한다. 간병변 진단과 같은 의료 진단에서 조영제의 전이와 확산 속도는 매우 중요한 요소가 된다. 이에 본 연구에서는 조영효과의 확산 패턴을 하나의 영상으로 표현하는 방법을 제시하였다. 이 과정에서 호흡에 의한 흔들림으로 인하여 영상의 정확도가 저하시키는 현상을 개선하기 위하여 호흡주기에 따른 동적 가중치와 모멘텀 요소를 사용하는 영상추적 기법을 제안하였다. 총 72개의 조영증강 데이터를 사용한 실험을 통하여, 제안된 기법이 초음파진단에서 육안 판별의 한계를 극복할 수 있게 하고, 호흡에 의한 흔들림을 보정함으로써 진단 파라미터의 신뢰도를 향상시킬 수 있음을 보인다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권6호
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• pp.2361-2368
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• 2015

Objective: To evaluate the diagnostic accuracy of contrast-enhanced ultrasonography (CEUS) in differentiating between benign and malignant enlarged lymph nodes using meta-analysis. Materials and Methods: Pubmed, Embase, SCI and Cochrane databases were searched for studies (up to September 1, 2014) reporting the diagnostic performance of CEUS in discriminating between benign and malignant lymph nodes. Inclusion criteria were: prospective study; histopathology as the reference standard; and sufficient data to construct $2{\times}2$ contingency tables. Methodological quality was assessed using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). Patient clinical characteristics, sensitivity and specificity were extracted. The summary receiver operating characteristic curve was used to examine the accuracy of CEUS. A meta-analysis was performed to evaluate the clinical utility in identification of benign and malignant lymph nodes. Sensitivity analysis was performed after omitting outliers identified in a bivariate boxplot and publication bias was assessed with Egger testing. Results: The pooled sensitivity, specificity and AUROC were 0.92 (95%CI, 0.85-0.96), 0.91 (95%CI, 0.82-0.95) and 0.97 (95%CI, 0.95-0.98), respectively. After omitting 3 outlier studies, heterogeneity decreased. Sensitivity analysis demonstrated no disproportionate influences of individual studies. Publication bias was not significant. Conclusions: CEUS is a promising diagnostic modality in differentiating between benign and malignant lymph nodes and can potentially reduce unnecessary fine-needle aspiration biopsies of benign nodes.

• Asian Pacific Journal of Cancer Prevention
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• 제15권19호
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• pp.8149-8153
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• 2014

Background: To compare the value of contrast-enhanced ultrasound (CEUS) qualitative and quantitative analysis in the identification of breast tumor lumps. Materials and Methods: Qualitative and quantitative indicators of CEUS for 73 cases of breast tumor lumps were retrospectively analyzed by univariate and multivariate approaches. Logistic regression was applied and ROC curves were drawn for evaluation and comparison. Results: The CEUS qualitative indicator-generated regression equation contained three indicators, namely enhanced homogeneity, diameter line expansion and peak intensity grading, which demonstrated prediction accuracy for benign and malignant breast tumor lumps of 91.8%; the quantitative indicator-generated regression equation only contained one indicator, namely the relative peak intensity, and its prediction accuracy was 61.5%. The corresponding areas under the ROC curve for qualitative and quantitative analyses were 91.3% and 75.7%, respectively, which exhibited a statistically significant difference by the Z test (P<0.05). Conclusions: The ability of CEUS qualitative analysis to identify breast tumor lumps is better than with quantitative analysis.

• Asian Pacific Journal of Cancer Prevention
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• 제13권8호
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• pp.3709-3712
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• 2012

This study evaluated the advantages and applications of contrast-enhanced ultrasound (CEUS)-supported percutaneous radiofrequency ablation (RFA) in the treatment of metastatic hepatocellular carcinoma after liver transplantation, based on clinical details. CEUS-supported percutaneous RFA was adopted to treat 12 patients with hepatic metastatic carcinomas after liver transplantation. The diameters of the metastatic carcinomas varied from 1 cm to 5 cm, and the foci were discovered after 3 months to 12 months. Each focus was diagnosed and localised by CEUS for RFA once or twice. Curative effects were evaluated by CEUS or contrast-enhanced CT after the treatment. The re-examination results at 2 weeks post-treatment showed that the foci of 11 patients were ablated completely, whereas one patient with the largest focus required retreatment by RFA because of a partial residue. No local recurrence was found one month later in the re-examination. CEUS-supported percutaneous RFA in the treatment of hepatic metastatic carcinoma after liver transplantation has the advantages of accurate localisation, good efficacy, easy operation, and minimal invasion without any complications. Therefore, it can be recommended as the preferred therapy for hepatic metastatic carcinoma after liver transplantation.

• Korean Journal of Radiology
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• 제22권3호
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• pp.354-365
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• 2021

Objective: To investigate the diagnostic performance of contrast-enhanced ultrasound (CEUS) and its role as a second-line imaging modality after gadoxetate-enhanced MRI (Gd-EOB-MRI) in the diagnosis of hepatocellular carcinoma (HCC) among at risk observations. Materials and Methods: We prospectively enrolled participants at risk of HCC with treatment-naïve solid hepatic observations (≥ 1 cm) of Liver Imaging Reporting and Data System (LR)-3/4/5/M during surveillance and performed Gd-EOB-MRI. A total of one hundred and three participants with 103 hepatic observations (mean size, 28.2 ± 24.5 mm; HCCs [n = 79], non-HCC malignancies [n = 15], benign [n = 9]; diagnosed by pathology [n = 57], or noninvasive method [n = 46]) were included in this study. The participants underwent CEUS with sulfur hexafluoride. Arterial phase hyperenhancement (APHE) and washout on Gd-EOB-MRI and CEUS were evaluated. The distinctive washout in CEUS was defined as mild washout 60 seconds after contrast injection. The diagnostic ability of Gd-EOB-MRI and of CEUS as a second-line modality for HCC were determined according to the European Association for the Study of the Liver (EASL) and the Korean Liver Cancer Association and National Cancer Center (KLCA-NCC) guidelines. The diagnostic abilities of both imaging modalities were compared using the McNemar's test. Results: The sensitivity of CEUS (60.8%) was lower than that of Gd-EOB-MRI (72.2%, p = 0.06 by EASL; 86.1%, p < 0.01 by KLCA-NCC); however, the specificity was 100%. By performing CEUS on the inconclusive observations in Gd-EOB-MRI, HCCs without APHE (n = 10) or washout (n = 12) on Gd-EOB-MRI further presented APHE (80.0%, 8/10) or distinctive washout (66.7%, 8/12) on CEUS, and more HCCs were diagnosed than with Gd-EOB-MRI alone (sensitivity: 72.2% vs. 83.5% by EASL, p < 0.01; 86.1% vs. 91.1% by KCLA-NCC, p = 0.04). There were no false-positive cases for HCC on CEUS. Conclusion: The addition of CEUS to Gd-EOB-MRI as a second-line diagnostic modality increases the frequency of HCC diagnosis without changing the specificities.

• Korean Journal of Radiology
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• 제23권11호
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• pp.1067-1077
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• 2022

Objective: To determine whether Sonazoid-enhanced ultrasound (SZUS) was noninferior to SonoVue-enhanced ultrasound (SVUS) in diagnosing hepatocellular carcinoma (HCC) using the same diagnostic criteria. Materials and Methods: This prospective, single-center, noninferiority study (NCT04847726) enrolled 105 at-risk participants (71 male; mean age ± standard deviation, 63 ± 11 years; range, 26-86 years) with treatment-naïve solid hepatic nodules (≥ 1 cm). All participants underwent same-day SZUS (experimental method) and SVUS (control method) for one representative nodule per participant. Images were interpreted by three readers (the operator and two independent readers). All malignancies were diagnosed histopathologically, while the benignity of other lesions was confirmed by follow-up stability or pathology. The primary endpoint was per-lesion diagnostic accuracy for HCC pooled across three readers using the conventional contrast-enhanced ultrasound diagnostic criteria, including arterial phase hyperenhancement followed by mild (assessed within 2 minutes after contrast injection) and late (≥ 60 seconds with a delay of 5 minutes) washout. The noninferiority delta was -10%p. Furthermore, different time delays were compared as washout criteria in SZUS, including delays of 2, 5, and > 10 minutes. Results: A total of 105 lesions (HCCs [n = 61], non-HCC malignancies [n = 19], and benign [n = 25]) were evaluated. Using the 5-minutes washout criterion, per-lesion accuracy of SZUS pooled across the three readers (72.4%; 95% confidence interval [CI], 64.1%-79.3%) was noninferior to that of SVUS (71.4%; 95% CI, 63.1%-78.6%), meeting the statistical criterion for non-inferiority (difference of 0.95%p; 95% CI, -3.8%p-5.7%p). The arterial phase hyperenhancement combined with the 5-minutes washout criterion showed the same sensitivity as that of the > 10-minutes criterion (59.0% vs. 59.0%, p = 0.989), and the specificities were not significantly different (90.9% vs. 86.4%, p = 0.072). Conclusion: SZUS was noninferior to SVUS for diagnosing HCC in at-risk patients using the same diagnostic criteria. No significant improvement in HCC diagnosis was observed by extending the washout time delay from 5 to 10 minutes.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권3호
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• pp.282-290
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• 2019

Characterizing inflammation and fibrosis in Crohn's disease (CD) is necessary to guide clinical management, but distinguishing the two remains challenging. Novel ultrasound (US) techniques: contrast-enhanced US (CEUS) and shear wave elastography (SWE) offer great potential in evaluating disease activity in pediatric patients. Three patients ages 16 to 20 with known CD underwent CEUS and SWE to characterize bowel wall inflammation and fibrosis. Magnetic resonance enterography, endoscopy, or surgical pathology findings are also described when available. The patients' disease activity included acute inflammation, chronic inflammation with stricture formation, and a fibrotic surgical anastomosis without inflammation. CEUS was useful in determining the degree of inflammation, and SWE identified bowel wall fibrosis. Used together these techniques allow for better characterization of the degree of fibrosis and inflammation in bowel strictures. With further validation CEUS and SWE may allow for improved characterization of bowel strictures and disease flares in pediatric patients suffering from CD.