Skip to main content
SpringerLink
Log in

Value of new contrast harmonic technique for detecting tumor vascularity in hepatocellular carcinoma: Preliminary results

  • Original Contribution
  • Published:
Journal of Medical Ultrasonics Aims and scope Submit manuscript

Abstract

Purpose: To investigate the value of a new wide-band contrast harmonic imaging method in depicting intratumoral vascularity in hepatocellular carcinoma.Materials and Methods: Twenty-two patients with 28 hepatocellular carcinoma nodules evaluated with Contrast Harmonic Echo, a new wide-band harmonic imaging method, using Levovist® as a contrast-enhancing agent. Intermittent imaging was carried out in the early arterial phase for 10 to 40 seconds, in the late vascular phase for 1 to 2 minutes, and in the postvascular phase for 5 to 7 minutes. Subtraction images were obtained using the multishot method during the late vascular phase. The ability of Contrast Harmonic Echo imaging to detect vascularity in hepatocellular carcinoma was compared to that of unenhanced color Doppler imaging by analzing results obtained using dynamic CT as a gold standard.Results: Contrast harmonic Echo imaging detected intratumoral vessels, tumor parenchymal stain, and perfusion defect in the early arterial phase, the late vascular phase, and the postvascular phase, respectively. In the late vascular phase, the subtraction image clearly delineated the tumor parenchymal strain. Intratumoral vascularity was detected in 25 (89%) of the hepatocellular carcinoma nodules by Contrast Harmonic Echo, compared with 15 (54%) when color Doppler imaging was used (p<0.05). The diagnostic sensitivity, specificity, and accuracy of Contrast Harmonic Echo were 96.1%, 100% and 96.4%, respectively, corresponding to results obtained using dynamic CT.Conclusion: Contrast Harmonic Echo imaging is superior to unenhanced color Doppler imaging in depicting intratumoral vessels and parenchymal stain, and agrees closely with results obtained with three-phase dynamic CT.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Takayasu K, Moriyama N, Muramatsu Y, et al: The diagnosis of small hepatocellular carcinoma: efficacy of various imaging procedures in 100 patients. AJR Am J Roentgenol 1990;155: 49–54.

    PubMed  CAS  Google Scholar 

  2. Menu Y: Hepatocellular carcinoma-radiological findings. Hepatogastroenterol 1998;45: 1232–1235.

    Google Scholar 

  3. Kudo M: Morphological diagnosis of hepatocellular carcinoma: special emphasis on intranodular hemodynamic imaging. Hepatogastroenterol 1998;45: 1226–1231.

    Google Scholar 

  4. Kudo M: Imaging diagnosis of hepatocellular carcinoma and premalignant/borderline lesions. Semin Liver Dis 1999;19: 297–309.

    Article  PubMed  CAS  Google Scholar 

  5. Tanaka S, Kitamura T, Fujita M, et al: Color Doppler flow imaging of liver tumors. AJR Am J Roentgenol 1990;154: 509–514.

    PubMed  CAS  Google Scholar 

  6. Koito K, Namieno T, Morita K: Differential diagnosis of small hepatocellular carcinoma and adenomatous hyperplasia with power Doppler sonography. AJR Am J Roentogenol 1998;170: 157–161.

    CAS  Google Scholar 

  7. Kawasaki T, Itani T, Nakase H, et al: Power Doppler imaging of hepatic tumors: differential diagnosis between hepatocellular carcinoma and metastatic adenocarcinoma. J Gastoenterol Hepatol 1998;13: 1152–1160.

    CAS  Google Scholar 

  8. Okuda K: Hepatocellular carcinoma: recent progress. Hepatology 1992;15: 948–961.

    PubMed  CAS  Google Scholar 

  9. Kudo M, Tomita S, Tochio H, et al: Sonography with intraarterial infusion of carbon dioxide microbubbles (sonographic angiography): value in differential diagnosis of hepatic tumors. AJR Am J Roentgenol 1992;158: 65–74.

    PubMed  CAS  Google Scholar 

  10. Ikeda K, Saito S, Koida I, et al: Imaging diagnosis of small hepatocellular carcinoma. Hepatology 1994;20: 82–87.

    Article  PubMed  CAS  Google Scholar 

  11. Takayasu K, Muramatsu Y, Furukawa H, et al: Early hepatocellular carcinoma: appearance at CT during arterial portography and CT arteriography with pathologic correlation. Radiology 1995;194: 101–105.

    PubMed  CAS  Google Scholar 

  12. Leen E, McArdle CS: Ultrasound contrast agents in liver imaging. Clin Radiol 1996;51 (suppl): 35–39.

    PubMed  Google Scholar 

  13. Cosgrove D: Ultrasound contrast enhancement of tumors. Clin Radiol 1996;51 (suppl): 44–49.

    PubMed  Google Scholar 

  14. Calliada F, Campani R, Bottinelli O: Ultrasound contrast agents: basic principles. Eur J Radiol 1998;27: s157-s160.

    Article  PubMed  Google Scholar 

  15. Maresca G, Summaria V, Colagrande C: New prospects for ultrsound contrast agents. Eur J Radiol 1998;27: s171-s178.

    Article  PubMed  Google Scholar 

  16. Burns PN: Harmonic imaging with ultrasound contrast agents. Clin Radiol 1996;51 (suppl): 50–55.

    PubMed  Google Scholar 

  17. Kono Y, Moriyasu F, Mine Y, et al: Gray-scale second harmonic imaging of the liver with galactose-based microbubbles. Invest Radiol 1997;32: 120–125.

    Article  PubMed  CAS  Google Scholar 

  18. Wilson SR, Burns PN, Muradali D, et al: Harmonic hepatic US with microbubble contrast agent: initial experience showing improved characterization of hemangioma, hepatocellular carcinoma, and metastasis. Radiology 2000;215: 153–161.

    PubMed  CAS  Google Scholar 

  19. Choi BI, Kim TK, Han JK, et al: Vascularity of hepatocellular carcinoma: assessment with contrast-enhanced second-harmonic versus conventional power Doppler US. Radiology 2000;214: 381–386.

    PubMed  CAS  Google Scholar 

  20. Kim TK, Choi BI, Han JK, et al: Hepatic tumors: contrast agent-enhancement patterns with pulseinversion harmonic US. Radiology 2000;216: 411–417.

    PubMed  CAS  Google Scholar 

  21. Burn PN, Wilson SR, Simpson DH: Pulse inversion imaging of liver blood flow: improved method for characterizing focal masses with microbubble contrast. Invest Radiol 2000;35: 58–71.

    Article  Google Scholar 

  22. Ding H, Kudo M, Onda H, et al: Contrast-enhanced subtraction harmonic sonography for evaluating treatment response in patients with hepatocellular carcinoma. AJR Am J Roentgenol 2001;176: 661–666.

    PubMed  CAS  Google Scholar 

  23. Numata K, Tanaka K, Kiba T, et al: Contrast-enhanced, wide-band harmonic gray scale imaging of hepatocellular carcinoma: correlation with helical computed tomographic findings. J Ultrasound Med 2001;20: 89–98.

    PubMed  CAS  Google Scholar 

  24. Strobel D, Krodel U, Martus P, et al: Clinical evaluation of contrast-enhanced color Doppler sonography in the differential diagnosis of liver tumors. J Clin Ultrasound 2000;28: 1–13.

    Article  PubMed  CAS  Google Scholar 

  25. Kim AY, Choi BI, Kim TK, et al: Hepatocellular carcinoma: power Doppler US with a contrast agent: preliminary results. Radiology 1998;209: 135–140.

    PubMed  CAS  Google Scholar 

  26. Forsberg F, Liu JB, Burns PN, et al: Artifacts in ultrasonic contrast agent studies. J Ultrasound Med 1994;13: 357–365.

    PubMed  CAS  Google Scholar 

  27. Kamiyama N, Moriyasu F, Mine Y, et al: Analysis of flash echo from contrast agent for designing optimal ultrasound diagnostic systems. Ultrasound Med Biol 1999;25: 411–420.

    Article  PubMed  CAS  Google Scholar 

  28. Kamiyama N, Moriyasu F, Kono Y, et al: Investigation of the “flash echo” signal associated with a US contrast agent. Radiology 1996;201 (p): 158.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Kinki University School of Medicine, 377-2, Ohno-Higashi, Osaka-Sayama, Osaka-Sayama, Japan

    Yan Ling Wen, Masatoshi Kudo, Yasunori Minami, Hobyung Chung, Yoichiro Suetomi, Hirokazu Onda, Masayuki Kitano & Toshihiko Kawasaki

  2. Abdominal Ultrasound Unit, Kinki University School of Medicine, 377-2, Ohno-Higashi, Osaka-Sayama, Osaka-Sayama, Japan

    Kiyoshi Maekawa

  3. Department of Ultrasound, Sun Yut-Sen University of Medical Science Memorial Hospital, 107 Yanjiangxi Rd, 510120, Guangzhou, China

    Yan Ling Wen

Authors
  1. Yan Ling Wen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Masatoshi Kudo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yasunori Minami
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hobyung Chung
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yoichiro Suetomi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hirokazu Onda
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Masayuki Kitano
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Toshihiko Kawasaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Kiyoshi Maekawa
    View author publications

    You can also search for this author in PubMed Google Scholar

About this article

Cite this article

Wen, Y.L., Kudo, M., Minami, Y. et al. Value of new contrast harmonic technique for detecting tumor vascularity in hepatocellular carcinoma: Preliminary results. J Med Ultrasonics 30, 85–92 (2003). https://doi.org/10.1007/BF02481368

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02481368

Keywords

Search

Navigation