The late phase of Contrat-Enhanced Ultrasonography (CEUS) and Magnetic Resonance (MRI) with hepatospecific contrast material (Gd-Bopta) in the characterization of focal liver lesions

Purpose: To evaluate the late phase of CEUS in comparison to MRI with Gd-BOPTA in the characterization of focal liver lesions in terms of benignity and malignancy.

Methods and material: 66 focal liver lesions (4 adenomas, 7 haemangiomas, 11 FNH, 4 regenerative nodules, 28 HCCs, 10l metastases, 2 cholangiocarcinomas) were studied with CEUS by using a 2nd generation microbubbles (Sonovue, Bracco, Italy) and MRI performed with 1.5 T machine with Gd-BOPTA (Multihance, Bracco, Milan, Italy). All malignant lesions were cito/hystologically proven. All benign lesions were followed-up.

Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values were calculated for the late phase of CEUS and late phase of Bopta MRI in discriminating between benign and malignant lesions. Accuracy of the association CEUS+MRI was also calculated.

Results: Sensitivity, specificity, PPV and NPV of late sinusoidal phase of CEUS were 85%, 69%, 81%, 75%,79% respectively. Sensitivity, specificity, PPV and NPV of late sinusoidal phase of MRI were 93,%,85%, 90%, 88% and 89% respectively. Sensitivity, specificity, PPV and NPV of the association between CEUS and MRI were 100%, 92%, 93%, 100% and 97% respectively.

Conclusions: The association between late phase CEUS and MRI in the characterization of focal liver lesions in terms of benignity and malignancy is more accurate than the two techniques separately.