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Purpose <p>To investigate the value of dynamic contrast-enhanced ultrasound (DCE-US) analysis using the Liver Imaging Reporting and Data System (LI-RADS) to improve the diagnosis of hepatocellular carcinoma (HCC).</p> Methods <p>This multicenter study retrospectively enrolled consecutive high-risk patients for HCC who underwent contrast-enhanced ultrasound (CEUS) between December 2022 and June 2023. Quantitative CEUS analysis was performed using VueBox<sup>®</sup> to obtain diagnostic parameters for HCC. These parameters were used as auxiliary indicators to reassign the LI-RADS categories. The reference standard was pathologic confirmation or composite criteria. The diagnostic performance of LI-RADS with and without quantitative DCE-US parameters was assessed.</p> Results <p>269 patients (median age, 61&#xa0;years [interquartile range, 52–69]; 206 men, 63 women) with 269 focal liver lesions (FLLs) (median size, 40&#xa0;mm [interquartile range, 25–62&#xa0;mm]) were included. Among the 269 FLLs, 227 were HCC, 31 non-HCC malignancies, and 11 benign lesions. DCE-US&#xa0;analysis showed HCC&#xa0;had higher rise time (RT) and fall time (FT) at the lesion margin&#xa0;than non-HCC malignancies (both <i>P</i> &lt; 0.05) but lower RT and FT than benign lesions (both <i>P</i> &lt; 0.05).&#xa0;RT at the lesion margin (range 17.48&#xa0;s–21.16&#xa0;s) serves as an auxiliary indicator for HCC diagnosis. Compared to CEUS LI-RADS, the revised LR-5 improved sensitivity (61.7 vs. 52.8%, <i>P</i> &lt; 0.001)&#xa0;without a significant decrease in specificity (76.2 vs. 83.3%,&#xa0;<i>P</i> = 0.25) for diagnosing HCC.</p> Conclusion <p>DCE-US&#xa0;quantitative&#xa0;analysis improved the sensitivity for HCC diagnosis without affecting specificity, thereby optimizing the diagnostic performance of CEUS LI-RADS.</p>

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Dynamic contrast-enhanced ultrasound with quantitative analysis optimizes LI-RADS for hepatocellular carcinoma diagnosis: a multicenter study

  • 期刊论文

  • 发表日期：

    2025年9月26日

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  • Ya-Qin Zhang,
  • Xi Wang,
  • Lin-Na Liu,
  • Xin-Yuan Hu,
  • Qing Lu,
  • Bo-Yang Zhou,
  • Han-Sheng Xia,
  • Hong Han,
  • Hui-Xiong Xu,
  • Chong-Ke Zhao

摘要

Purpose

To investigate the value of dynamic contrast-enhanced ultrasound (DCE-US) analysis using the Liver Imaging Reporting and Data System (LI-RADS) to improve the diagnosis of hepatocellular carcinoma (HCC).

Methods

This multicenter study retrospectively enrolled consecutive high-risk patients for HCC who underwent contrast-enhanced ultrasound (CEUS) between December 2022 and June 2023. Quantitative CEUS analysis was performed using VueBox® to obtain diagnostic parameters for HCC. These parameters were used as auxiliary indicators to reassign the LI-RADS categories. The reference standard was pathologic confirmation or composite criteria. The diagnostic performance of LI-RADS with and without quantitative DCE-US parameters was assessed.

Results

269 patients (median age, 61 years [interquartile range, 52–69]; 206 men, 63 women) with 269 focal liver lesions (FLLs) (median size, 40 mm [interquartile range, 25–62 mm]) were included. Among the 269 FLLs, 227 were HCC, 31 non-HCC malignancies, and 11 benign lesions. DCE-US analysis showed HCC had higher rise time (RT) and fall time (FT) at the lesion margin than non-HCC malignancies (both P < 0.05) but lower RT and FT than benign lesions (both P < 0.05). RT at the lesion margin (range 17.48 s–21.16 s) serves as an auxiliary indicator for HCC diagnosis. Compared to CEUS LI-RADS, the revised LR-5 improved sensitivity (61.7 vs. 52.8%, P < 0.001) without a significant decrease in specificity (76.2 vs. 83.3%, P = 0.25) for diagnosing HCC.

Conclusion

DCE-US quantitative analysis improved the sensitivity for HCC diagnosis without affecting specificity, thereby optimizing the diagnostic performance of CEUS LI-RADS.