Diagnostic performance of Sonazoid-enhanced CEUS in identifying definitive hepatocellular carcinoma in cirrhotic patients according to KLCA-NCC 2022 and APASL 2017 guidelines.

IF 4.1 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Insights into Imaging Pub Date : 2024-10-31 DOI:10.1186/s13244-024-01838-x

Zhe Huang, Rong-Hua Zhu, Shan-Shan Li, Hong-Chang Luo, Kai-Yan Li

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引用次数: 0

Abstract

Objective: This study aims to assess the diagnostic performance of Sonazoid-contrast-enhanced ultrasound (CEUS) in identifying definitive HCC within hepatic nodules in cirrhotic patients, comparing the KLCA-NCC 2022 and APASL 2017 diagnostic guidelines.

Materials and methods: This retrospective study analyzed cirrhotic patients who underwent Sonazoid-CEUS for liver lesion evaluation between October 2019 and October 2023. HCC diagnosis was based on the KLCA-NCC 2022 and APASL 2017 guidelines. Inter-reader agreement on CEUS imaging features and the diagnostic accuracy of the guidelines were evaluated. Sensitivity and specificity comparisons were made using McNemar's test.

Results: Among 400 patients with 432 lesions, CEUS showed excellent inter-reader consistency in detecting arterial phase hyperenhancement and Kupffer defects. The KLCA-NCC 2022 criteria notably enhanced sensitivity to 96.2%, with specificity and accuracy of 93.8% and 95.8%, respectively. APASL 2017 achieved the highest sensitivity at 97.8%, although specificity dropped to 46.9%, resulting in an accuracy of 90.3%. The KLCA-NCC 2022 guidelines demonstrated significantly higher specificity than APASL 2017 (p < 0.001), while APASL 2017 exhibited the highest sensitivity at 97.8%. Notably, the KLCA-NCC 2022 guidelines also demonstrated an impressive positive predictive value of 98.9%.

Conclusion: Sonazoid-enhanced CEUS, particularly when applied using the KLCA-NCC 2022 guidelines, is an effective diagnostic tool for HCC.

Critical relevance statement: Perfluorobutane CEUS, particularly in accordance with the KLCA-NCC 2022 guidelines, emerges as a valuable adjunct for diagnosing HCC in cirrhotic patients. It demonstrates superior positive predictive value and specificity compared to APASL 2017, underscoring its potential as an effective diagnostic tool.

Key points: Contrast-enhanced (CE)US using Sonazoid with KLCA-NCC 2022 guidelines is highly effective for HCC diagnosis. KLCA-NCC 2022 criteria showed high accuracy, 96.2% sensitivity, and 98.9% PPV. CEUS demonstrated excellent inter-reader consistency in detecting arterial phase hyperenhancement and Kupffer defects.

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根据 KLCA-NCC 2022 和 APASL 2017 指南，Sonazoid 增强 CEUS 在肝硬化患者中确定性肝细胞癌的诊断性能。

研究目的本研究旨在评估Sonazoid-对比增强超声（CEUS）在肝硬化患者肝结节内确定性HCC的诊断性能，比较KLCA-NCC 2022和APASL 2017诊断指南：这项回顾性研究分析了2019年10月至2023年10月期间接受Sonazoid-CEUS肝脏病变评估的肝硬化患者。HCC 诊断基于 KLCA-NCC 2022 和 APASL 2017 指南。对CEUS成像特征的读片者之间的一致性以及指南的诊断准确性进行了评估。采用McNemar检验对敏感性和特异性进行比较：结果：在400名患者的432个病灶中，CEUS在检测动脉期高强化和Kupffer缺损方面显示出极好的读片者间一致性。KLCA-NCC 2022标准显著提高了灵敏度，达到96.2%，特异性和准确性分别为93.8%和95.8%。APASL 2017 的灵敏度最高，达到 97.8%，但特异性降至 46.9%，准确性为 90.3%。KLCA-NCC 2022指南显示的特异性明显高于APASL 2017（P 结论：类 Sonazoid 增强 CEUS，尤其是在使用 KLCA-NCC 2022 指南时，是一种有效的 HCC 诊断工具：全氟丁烷CEUS，尤其是根据KLCA-NCC 2022指南，是诊断肝硬化患者HCC的重要辅助手段。与 2017 年 APASL 相比，它显示出更高的阳性预测值和特异性，凸显了其作为有效诊断工具的潜力：要点：根据 KLCA-NCC 2022 标准使用 Sonazoid 进行对比增强 (CE) US 对 HCC 诊断非常有效。KLCA-NCC 2022标准显示了较高的准确性，灵敏度为96.2%，PPV为98.9%。CEUS在检测动脉期高强化和Kupffer缺损方面表现出了极好的读数一致性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Insights into Imaging Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

7.30

自引率

4.30%

发文量

182

审稿时长

13 weeks

期刊介绍： Insights into Imaging (I³) is a peer-reviewed open access journal published under the brand SpringerOpen. All content published in the journal is freely available online to anyone, anywhere! I³ continuously updates scientific knowledge and progress in best-practice standards in radiology through the publication of original articles and state-of-the-art reviews and opinions, along with recommendations and statements from the leading radiological societies in Europe. Founded by the European Society of Radiology (ESR), I³ creates a platform for educational material, guidelines and recommendations, and a forum for topics of controversy. A balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes I³ an indispensable source for current information in this field. I³ is owned by the ESR, however authors retain copyright to their article according to the Creative Commons Attribution License (see Copyright and License Agreement). All articles can be read, redistributed and reused for free, as long as the author of the original work is cited properly. The open access fees (article-processing charges) for this journal are kindly sponsored by ESR for all Members. The journal went open access in 2012, which means that all articles published since then are freely available online.