Dataset Information

Contrast-enhanced ultrasound features of malignant focal liver masses in dogs.

ABSTRACT: A total of 185 cases (150 retrospectively and 35 prospectively) of malignant liver masses were collected. In the retrospectively collected cases hyperenhancement during wash-in was the most common feature in HCCs but there was a high percentage of cases showing no enhancement or hypo/isoenhancement. ICCs displayed a large variety of contrast enhancement patterns and, although statically significant differences between ICCs and HCCs were evident, no clear distinction between these two pathologies was possible based only on their CEUS appearance. Sarcomas displayed all the possible degrees of wash-in enhancement with non-enhancing being the most common appearance. Metastases displayed all the possible contrast-enhancement patterns, with the most common being hyperenhancement in the wash-in phase followed by hypoenhancement in the wash-out phase. A decision tree was developed based on the features of the retrospectively selected cases. Based on the developed decision tree 27/35 prospectively collected cases were correctly classified. Even if some significant differences among groups were evident, all the histotypes displayed all the possible patterns of contrast enhancement, and, therefore, the differentiation of liver masses in dogs based only on their CEUS features is not feasible and, therefore, cytology or histopathology is required.

SUBMITTER: Burti S

PROVIDER: S-EPMC7142119 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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Contrast-enhanced ultrasound features of malignant focal liver masses in dogs.

Burti Silvia S Zotti Alessandro A Rubini Giuseppe G Orlandi Riccardo R Bargellini Paolo P Bonsembiante Federico F Banzato Tommaso T

Scientific reports 20200408 1

A total of 185 cases (150 retrospectively and 35 prospectively) of malignant liver masses were collected. In the retrospectively collected cases hyperenhancement during wash-in was the most common feature in HCCs but there was a high percentage of cases showing no enhancement or hypo/isoenhancement. ICCs displayed a large variety of contrast enhancement patterns and, although statically significant differences between ICCs and HCCs were evident, no clear distinction between these two pathologies ...[more]

PMID: 32269300

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Project description:BackgroundThe UK's National Institute for Health and Care Excellence (NICE) has recommended contrast-enhanced ultrasound (CEUS) for the characterisation of focal liver lesions where the results of standard unenhanced ultrasound are inconclusive. A further recommendation is for CEUS to replace other imaging modalities. However, little is currently known about the diagnostic pathways in the National Health Service (NHS) followed by patients with potential liver lesions. The aim of this study was to identify the diagnostic pathways for a number of representative hospital trusts and record the clinicians' views on patient experiences of these processes through a series of semi-structured interviews with UK clinicians (radiologists and sonographers) (N = 7). This study was undertaken in the broader context of a larger research project where the overarching research question is focused on patient preferences for CEUS and other imaging modalities, and how these impact on patient quality of life (QOL).ResultsThe results from the semi-structured interviews with UK clinicians revealed that there is a great deal of heterogeneity in diagnostic pathways followed by patients with potential liver lesions which differ both within and between hospitals. In terms of the patient experience, the clinicians believed that a combination of the more patient-friendly ultrasound process, and the fact that scan results are given to patients in 80-90% of cases on the day, as well as the problems inherent to other scan modalities (claustrophobia, anxiety) would lead to patients preferring ultrasound compared with other imaging modalities (CT or MR). However, current clinical practice means that patient choice is virtually non-existent.ConclusionsThe significant variation in diagnostic pathways across the NHS will require further standardisation through local agreements if contrast-enhanced ultrasound is to replace other imaging modalities in characterising focal liver lesions in line with NICE Diagnostics Guidance. The gradual development of patient choice of modalities may necessitate a change of practice in radiology processes.

Project description:Purpose To assess the performance of computer-aided diagnosis (CAD) systems and to determine the dominant ultrasonographic (US) features when classifying benign versus malignant focal liver lesions (FLLs) by using contrast material-enhanced US cine clips. Materials and Methods One hundred six US data sets in all subjects enrolled by three centers from a multicenter trial that included 54 malignant, 51 benign, and one indeterminate FLL were retrospectively analyzed. The 105 benign or malignant lesions were confirmed at histologic examination, contrast-enhanced computed tomography (CT), dynamic contrast-enhanced magnetic resonance (MR) imaging, and/or 6 or more months of clinical follow-up. Data sets included 3-minute cine clips that were automatically corrected for in-plane motion and automatically filtered out frames acquired off plane. B-mode and contrast-specific features were automatically extracted on a pixel-by-pixel basis and analyzed by using an artificial neural network (ANN) and a support vector machine (SVM). Areas under the receiver operating characteristic curve (AUCs) for CAD were compared with those for one experienced and one inexperienced blinded reader. A third observer graded cine quality to assess its effects on CAD performance. Results CAD, the inexperienced observer, and the experienced observer were able to analyze 95, 100, and 102 cine clips, respectively. The AUCs for the SVM, ANN, and experienced and inexperienced observers were 0.883 (95% confidence interval [CI]: 0.793, 0.940), 0.829 (95% CI: 0.724, 0.901), 0.843 (95% CI: 0.756, 0.903), and 0.702 (95% CI: 0.586, 0.782), respectively; only the difference between SVM and the inexperienced observer was statistically significant. Accuracy improved from 71.3% (67 of 94; 95% CI: 60.6%, 79.8%) to 87.7% (57 of 65; 95% CI: 78.5%, 93.8%) and from 80.9% (76 of 94; 95% CI: 72.3%, 88.3%) to 90.3% (65 of 72; 95% CI: 80.6%, 95.8%) when CAD was in agreement with the inexperienced reader and when it was in agreement with the experienced reader, respectively. B-mode heterogeneity and contrast material washout were the most discriminating features selected by CAD for all iterations. CAD selected time-based time-intensity curve (TIC) features 99.0% (207 of 209) of the time to classify FLLs, versus 1.0% (two of 209) of the time for intensity-based features. None of the 15 video-quality criteria had a statistically significant effect on CAD accuracy-all P values were greater than the Holm-Sidak α-level correction for multiple comparisons. Conclusion CAD systems classified benign and malignant FLLs with an accuracy similar to that of an expert reader. CAD improved the accuracy of both readers. Time-based features of TIC were more discriminating than intensity-based features. © RSNA, 2017 Online supplemental material is available for this article.

Dataset Information

Contrast-enhanced ultrasound features of malignant focal liver masses in dogs.

Publications

Contrast-enhanced ultrasound features of malignant focal liver masses in dogs.

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