Improved detection of hepatic metastases with pulse-inversion US during the liver-specific phase of SHU 508A: multicenter study.

Abstract

PURPOSE:

To compare conventional B-mode ultrasonography (US) alone with the combination of conventional B-mode US and contrast material-enhanced (SHU 508A) late-phase pulse-inversion US for the detection of hepatic metastases by using dual-phase spiral computed tomography (CT) as the standard of reference.

MATERIALS AND METHODS:

One hundred twenty-three patients underwent conventional US, US in the liver-specific phase of SHU 508A, and single-section spiral CT. US and CT images were assessed by blinded readers. Differences in sensitivity, specificity, and the number and smallest size of metastases at conventional and contrast-enhanced US were compared by using CT as the standard of reference. Lesion conspicuity was assessed objectively (quantitatively) and subjectively by one reader before and after contrast material administration.

RESULTS:

In 45 of 80 (56%) patients with metastases, more metastases were seen at contrast-enhanced US than at conventional US. In three of these patients, conventional US images appeared normal. The addition of contrast-enhanced US improved sensitivity for the detection of individual metastases from 71% to 87% (P <.001). On a patient basis, sensitivity improved from 94% to 98% (P =.44), and specificity improved from 60% to 88% (P <.01). Contrast enhancement improved the subjective conspicuity of metastases in 66 of 75 (88%) patients and the objective contrast by a mean of 10.8 dB (P <.001). Contrast-enhanced US showed more metastases than did CT in seven patients, and CT showed more than did contrast-enhanced US in one of 22 patients in whom an independent reference (magnetic resonance imaging, intraoperative US, or pathologic findings) was available.

CONCLUSION:

Contrast-enhanced US improved sensitivity and specificity in the detection of hepatic metastases.

• Authors: Thomas Albrecht, Martin J K Blomley, Peter N Burns, Stephanie Wilson, Christopher J Harvey, Edward Leen, Michel Claudon, Fabrizio Calliada, Jean-Michel Correas, Michel LaFortune, Rodolfo Campani, Christian W Hoffmann, David O Cosgrove, Frederic LeFevre
• Journal: Radiology (Radiology) Vol. 227 Issue 2 Pg. 361-70 (May 2003) ISSN: 0033-8419 [Print] United States
• PMID: 12649417 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: Copyright RSNA, 2003

Chemical References

• Contrast Media
• Polysaccharides
• SHU 508

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Contrast Media
• Female
• Humans
• Liver Neoplasms (diagnostic imaging, secondary)
• Male
• Middle Aged
• Polysaccharides
• Sensitivity and Specificity
• Ultrasonography (methods)