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Clinical Use of Contrast-Enhanced Ultrasound in Diagnosing Hepatocellular Carcinoma

By: Vanessa A. Carter, BS
Posted: Friday, May 19, 2023

The contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS) may be a useful tool in diagnosing hepatocellular carcinoma in patients without LI-RADS–defined risk factors, suggested Kaiyan Li, MD, of Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China, and colleagues. According to the authors, the results of this trial, which were published in Cancer Imaging, may offer insight into the classification of this type of liver cancer.

“In patients with and without hepatocellular carcinoma–associated risk factors, the CEUS LI-RADS category 5 criteria also show clinical value for diagnosis of hepatocellular carcinoma,” the investigators concluded. “Patients categorized as CEUS LI-RADS category 4 in the risk factor–negative group require more careful and comprehensive consideration by clinicians.”

This retrospective study focused on 823 patients with hepatocellular carcinoma with (n = 315) or without (n = 388) LI-RADS–defined risk factors; a validation set was established using a prospective evaluation in the same center (n = 120). The diagnostic performances of the CEUS LI-RADS among both cohorts were compared.

The LI-RADS category 5 specificities for diagnosing hepatocellular carcinoma in the risk factor–positive group were not significantly different from the risk factor–negative group (77.5% vs. 91.6%). Nonetheless, the positive prognostic value of CEUS LI-RADS category 5 was significantly higher among patients who were risk factor–positive than those who were risk factor–negative (P = .029).

Similarly, the positive prognostic value for hepatocellular carcinoma lesions among patients who were risk factor–positive was higher compared with those with risk factor–negative disease in the prospective study (P = .03). Of note, sensitivity and specificity did not differ between both groups.

Disclosure: The study authors reported no conflicts of interest.

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