3D analysis is superior to 2D analysis for contrast-enhanced ultrasound in revealing vascularity in focal liver lesions - A retrospective analysis of 83 cases.

OBJECTIVE: To examine whether dynamic 3D contrast-enhanced ultrasound (CEUS) is superior to 2D imaging in revealing vascularization of focal liver lesions (FLLs). METHODS: Dynamic 2D and 3D CEUS were used to assess the vascularity of FLLs in 83 patients. The two analyses were carried out sequentially following a bolus intravenous injection of SonoVue contrast agent, one injection of 1.5-2mL was given for each part of the study (one for the 2D and another for the 3D). Due to the large data volume for 3D analysis, only the arterial phase (20-25s) was recorded and analyzed. The data were analyzed by two independent analysts. RESULTS: The current study included a total of 83 patients with FLL. The diagnosis was established based on histopathology, Computed Tomography (CT), and magnetic resonance imaging (MRI). Among the 83 cases, 61 were hepatocellular carcinomas (include 10 metastasis, 51 HCCs), and the remaining 22 were benign lesions: hemangiomas (n=15), focal nodular hyperplasias (n=4), and inflammatory lesions (n=3). The overall analysis showed similar patterns of enhancement between the 2D and 3D CEUS in the following features: morphological characteristics, and spatial relationships. In comparison to 2D imaging, 3D CEUS reveal more details of the boundary and feeding arteries of the lesions, as well as distorted features of supply vessels of hepatocellular carcinomas. CONCLUSIONS: Dynamic 3D-CEUS is superior to 2D-CEUS in displaying the spatial relationship of FLLs and their vascularity patterns, and simultaneous imaging of FLL perfusion and anatomic features.

Acoustic Radiation Force Impulse imaging for detecting thyroid nodules: a systematic review and pooled meta-analysis.

AIM: To investigate the diagnostic performance of shear wave velocity (SWV) using virtual touch tissue quantification (VTQ) of acoustic radiation force impulse imaging (ARFI) technology in differentiating malignant and benign thyroid nodules by conducting a meta-analysis. MATERIAL AND METHODS: The Cochrane library, Embase, Pubmed, and Web of Science were searched for relevant studies through December 2014. Studies evaluating the diagnostic accuracy of SWV in the identification of malignant and benign thyroid nodules by using VTQ of ARFI technology were selected. The cytology or histology was used as the reference standard. The pooled sensitivity, specificity, diagnostic odds ratio, likelihood ratio, and the area under the summary receiver operating characteristic (SROC) curve were used to examine the diagnostic accuracy of SWV. RESULTS: A total of 13 cohort studies involving 1617 thyroid nodules from 1451 patients were identified. Of 13 studies, one was a retrospective study and others were prospective studies. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of SWV in differentiating malignant and benign thyroid nodules were 86.3% (95%CI: 78.2-91.7), 89.5% (95%CI: 83.3-93.6), 7.04 (95%CI: 4.40-11.26), 0.17 (95%CI: 0.10-0.31), and 46.66 (95%CI:19.47-111.81), respectively. The area under the SROC curve was 94% (95% CI: 92-96). CONCLUSIONS: This meta-analysis indicates that VTQ is useful in evaluating the stiffness of thyroid nodules and differentiating between malignant and benign nodules. Due to the high sensitivity, specificity, and diagnostic odds ratio, SWV can be considered as a useful complement for conventional ultrasonography.