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Ultrasomics in liver cancer: Developing a radiomics model for differentiating intrahepatic cholangiocarcinoma from hepatocellular carcinoma using contrast-enhanced ultrasound

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World Journal of Radiology 2024年第7期16卷 247-255页

作者： Li-Ya Su Ming Xu Yan-Lin Chen Man-Xia Lin Xiao-Yan Xie Department of Medical ultrasound The First Affiliated HospitalInstitute of Diagnostic and Interventional UltrasoundSun Yat-Sen UniversityGuangzhou 510000Guangdong ProvinceChina

BACKGROUND Hepatocellular carcinoma(HCC)and intrahepatic cholangiocarcinoma(ICC)represent the predominant histological types of primary liver cancer,comprising over 99%of *** their differing biological behaviors,prognoses,and treatment strategies,accurately differentiating between HCC and ICC is crucial for effective clinical ***,an emerging image processing technology,can automatically extract various quantitative image features that may elude the human *** on the application of ultrasound(US)-based radiomics methods in distinguishing HCC from ICC are *** In our retrospective study,we included a total of 280 patients who were diagnosed with ICC(n=140)and HCC(n=140)between 1999 and *** patients were divided into training(n=224)and testing(n=56)groups for *** images and relevant clinical characteristics were *** utilized the XGBoost method to extract and select radiomics features and further employed a random forest algorithm to establish ultrasomics *** compared the diagnostic performances of these ultrasomics models with that of *** Four distinct ultrasomics models were constructed,with the number of selected features varying between models:13 features for the US model;15 for the contrast-enhanced ultrasound(CEUS)model;13 for the combined US+CEUS model;and 21 for the US+CEUS+clinical data *** US+CEUS+clinical data model yielded the highest area under the receiver operating characteristic curve(AUC)among all models,achieving an AUC of 0.973 in the validation cohort and 0.971 in the test *** performance exceeded even the most experienced radiologist(AUC=0.964).The AUC for the US+CEUS model(training cohort AUC=0.964,test cohort AUC=0.955)was significantly higher than that of the US model alone(training cohort AUC=0.822,test cohort AUC=0.816).This finding underscored the significant benefit of incorporating CEUS information in accurately distin-guishing ICC from HC

关键词： Cholangiocarcinoma Hepatocellular carcinoma contrast-enhanced ultrasound Radiomics Primary liver tumor

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Evaluating the efficacy of percutaneous puncture biopsy guided by contrast-enhanced ultrasound for peripheral pulmonary lesions

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World Journal of Clinical Cases 2024年第19期12卷 3791-3799页

作者： Xiao Jiang Jun Chen Fang-Fang Gu Zhong-Rong Li Yu-Shan Song Jing-Jing Long Shu-Zhen Zhang Ting-Ting Xu Yong-Jun Tang Ji-Ying Gu Xiang-Ming Fang Department of Ultrasonography Shidong HospitalYangpu DistrictShidong Hospital Affiliated to University of Shanghai for Science and TechnologyShanghai 200438China Department of Ultrasonography The Affiliated Wuxi People's Hospital of Nanjing Medical UniversityWuxi People's HospitalWuxi Medical CenterNanjing Medical UniversityWuxi 214023Jiangsu ProvinceChina Department of Radiology The Affiliated Wuxi People's Hospital of Nanjing Medical UniversityWuxi People's HospitalWuxi Medical CenterNanjing Medical UniversityWuxi 214023Jiangsu ProvinceChina

BACKGROUND The incidence and mortality of lung cancer have increased *** diagnosis can help improve therapeutic efficacy of interventions and *** lung biopsy is a reliable method for the clinical diagnosis of lung ***-guided percutaneous lung biopsy technology has been widely promoted and applied in recent *** To investigate the diagnostic value of contrast-enhanced ultrasound(CEUS)-guided percutaneous biopsy in peripheral pulmonary *** We retrospectively collected data on 237 patients with peripheral thoracic focal lesions who underwent puncture biopsy at Wuxi People’s *** patients were randomly divided into two groups:The CEUS-guided before lesion puncture group(contrast group)and conventional ultrasound-guided group(control group).Analyze the diagnostic efficacy of the puncture biopsy,impact of tumor size,and number of puncture needles and complications were analyzed and compared between the two *** Accurate pathological results were obtained for 92.83%(220/237)of peripheral lung lesions during the first biopsy,with an accuracy rate of 95.8%(113/118)in the contrast group and 89.9%(107/119)in the control *** difference in the area under the curve(AUC)between the contrast and the control groups was not statistically significant(0.952 vs 0.902,respectively;P>0.05).However,when the lesion diameter≥5 cm,the diagnostic AUC of the contrast group was higher than that of the control group(0.952 vs 0.902,respectively;Pcontrast group was lower than that in the control group(2.58±0.53 vs 2.90±0.56,respectively;P<0.05).CONCLUSION CEUS guidance can enhance the efficiency of puncture biopsy of peripheral pulmonary lesions,especially for lesions with a diameter≥5 ***,CEUS guidance has high clinical diagnostic value in puncture biopsy of peripheral focal lung lesions.

关键词： contrast-enhanced ultrasound Peripheral lung lesions ultrasound guidance Biopsy Peripheral thoracic focal lesions

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ultrasound,contrast-enhanced ultrasound and pyelonephritis:A narrative review

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World Journal of Nephrology 2024年第3期13卷 1-8页

作者： Andrea Boccatonda Roberta Stupia Carla Serra Department of Medical and Surgical Sciences(DIMEC) University of BolognaBologna 40126Italy Department of General Medicine C Azienda Ospedaliera Universitaria Integrata of VeronaUniversity of VeronaVerona 37134Italy Department of Medical Liver Transplant Care General and University Hospital S.Orsola-MalpighiBologna 40138Italy

Acute pyelonephritis(APN)is a bacterial infection resulting in kidney inflammation,typically arising as a complication of an ascending urinary tract infection that ascends from the bladder to the *** diagnosis is generally based on clinical and laboratory *** guidelines recommend not performing diagnostic imaging unless a complicated APN is suspected or the infection affects high-risk patients such as the elderly,immunocompromised individuals,or ***-enhanced ultrasound(CEUS)is a valuable tool in both the diagnosis and follow-up of *** aids in distinguishing small simple nephritic involvement from abscess complications and monitoring their evolution over time during antibiotic *** its lack of ionizing radiation and nephrotoxicity,CEUS is a valid diagnostic modality for approaching and monitoring pyelonephritis,improving early identification and characterization of inflammatory *** review aims to summarize the main evidence on the use of ultrasound and CEUS in the diagnosis of APN and its follow-up.

关键词： Pyelonephritis contrast-enhanced ultrasound Kidney Abscess Urinary infection

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contrast-enhanced ultrasound as a valuable imaging modality for characterizing testicular lesions

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Asian Journal of Andrology 2022年第2期24卷 201-206页

作者： Jie Yu Xin-Hui Jiang Lian-Fang Du Min Bai Zhao-Jun Li Qiu-Sheng Shi Qi Jiang Fan Li Department of ultrasound Shanghai General HospitalShanghai Jiao Tong University School of MedicineShanghai 201620China Department of Medical ultrasound Shanghai Baoshan Hospital of Integrated Traditional Chinese and Western MedicineShanghai 201999China Department of Urology Shanghai General HospitalShanghai Jiao Tong University School of MedicineShanghai 200080China

contrast-enhanced ultrasound(CEUS)is a new form of ultrasound(US)that can dynamically display microvessels in a highly sensitive *** purpose of this study was to investigate the efficacy of CEUS for characterizing testicular lesions in comparison with conventional ***-seven patients with testicular lesions were *** histopathology results revealed that 31 cases were neoplastic(11 cases of seminomas,8 nonseminomatous germ cell tumors,8 lymphomas,2 Leydig cell tumors,and 2 nonspecific tumors),and 16 cases were nonneoplastic(8 cases of infarctions,3 epidermoid cysts,and 5 inflammation).The indicators of shallow lobulated morphology and cystic-solid echogenicity on conventional US were suggestive of germ cell *** indicators on CEUS were found to be useful for characterizing testicular *** the neoplastic lesions showed hyperenhancement on ***,germ cell tumors presented with heterogeneous enhancement(73.7%,14/19),a twisted blood vessel pattern,rapid wash-in and wash-out,and peripheral rim hyperenhancement *** was characterized by nonbranching linear vessel patterns(87.5%,7/8),rapid wash-in and slow *** nonneoplastic lesions,infarction and epidermoid cysts showed no enhancement,and abscesses were observed with marginal irregular *** sensitivity,specificity,and accuracy of CEUS for differentiating between neoplastic and nonneoplastic lesions were 100%,93.8%,and 97.9%,respectively,and these values were higher than those for conventional US(90.3%,62.5%,and 80.9%,respectively).CEUS can sensitively reflect the microvascular perfusion in testicular lesions and offers high accuracy for characterizing them.

关键词： characterization contrast-enhanced ultrasound diagnosis testicular neoplasms ultrasound

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contrast-enhanced ultrasound:Improving the preoperative staging of hepatocellular carcinoma and guiding individual treatment

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World Journal of Gastroenterology 2014年第35期20卷 12628-12636页

作者： Xiao-Yun Zhang Yan Luo Tian-Fu Wen Li Jiang Chuan Li Xiao-Fei Zhong Jing-Yi Zhang Wen-Wu Ling Lu-Nan Yan Yong Zeng Hong Wu Department of Liver Surgery and Liver Transplantation Centre West China Hospital of Sichuan University Department of Sonography West China Hospital of Sichuan University

AIM: To investigate the clinical role of contrast-enhanced ultrasound (CEUS) combined with contrast-enhanced computed tomography (CE-CT) or magnetic resonance imaging to improve the preoperative staging of hepatocellular carcinoma (HCC) and guide surgical decision-making. METHODS: Sixty-nine patients who underwent liver resection for HCC in our center were enrolled prospectively in the study. CEUS and CE-CT/MRI were performed before surgery. Intraoperative ultrasound (IOUS) was carried out after liver mobilization. Lesions depicted by each imaging modality were counted and mapped. To investigate the impact of tumor size on the study, we divided the patients into two groups, the 'Smaller group'(S-group, 5 cm in diameter). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of CE-CT/MRI, CEUS, IOUS, CEUS+CE-CT/MRI and the tumor node metastasis staging of tumors were calculated and compared. Changes in the surgical strategy as a result of CEUS and IOUS were analyzed. RESULTS: One hundred and twenty-seven nodules, comprising 94 HCCs confirmed by histopathology and 33 benign lesions confirmed by histopathology and follow-up, were identified in 69 patients. The overall diagnostic sensitivity rates of CE-CT/MRI, CEUS, IOUS and CEUS+ CE-CT/MRI were 78.7%, 89.4%, 89.4% and 89.4%, respectively. There was a significant difference between CEUS + CE-CT/MRI and CE-CT/MRI (P = 0.046). Combining CEUS with CT or MRI increased, the diagnostic specificity compared with CT/MRI, CEUS and IOUS, and this difference was statistically significant (100%, 72.7%, 97.0%, and 69.7%, P = 0.004, P = 0.002, P = 0.002, respectively). The diagnostic accuracy was significantly higher for CEUS + CT/MRI compared with CT/MRI (92.1% vs 77.2%, P = 0.001). The TNM staging of tumors based on CEUS + CE-CT/MRI approximated to the final pathological TNM staging (P = 0.977). There was a significant difference in t

关键词： Hepatocellular carcinoma contrast-enhanced ultrasound Tumor node metastasis staging Intraoperative ultrasound Liver resection

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contrast-enhanced ultrasound Liver Imaging Reporting and Data System:Lights and shadows in hepatocellular carcinoma and cholangiocellular carcinoma diagnosis

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World Journal of Gastroenterology 2022年第27期28卷 3488-3502页

作者： Gianpaolo Vidili Marco Arru Giuliana Solinas Diego Francesco Calvisi Pierluigi Meloni Assunta Sauchella Davide Turilli Claudio Fabio Antonio Cossu Giordano Madeddu Sergio Babudieri Maria Assunta Zocco Giovanni Iannetti Enza Di Lembo Alessandro Palmerio Delitala Roberto Manetti Department of Medical Surgical and Experimental SciencesUniversity of SassariSassari 07100Italy Department of Biomedical Sciences Public Health-Laboratory of BiostatisticsUniversity of SassariSassari 07100Italy Department of Internal Medicine and Gastroenterology Fondazione Policlinico Universitario A.Gemelli IRCCSCatholic UniversityRome 00168Italy ultrasound Unit Ospedale S.SpiritoPescara 65123Italy

BACKGROUND contrast-enhanced ultrasound(CEUS)is considered a secondary examination compared to computed tomography(CT)and magnetic resonance imaging(MRI)in the diagnosis of hepatocellular carcinoma(HCC),due to the risk of misdiagnosing intrahepatic cholangiocarcinoma(ICC).The introduction of CEUS Liver Imaging Reporting and Data System(CEUS LI-RADS)might overcome this *** though data from the literature seems promising,its reliability in real-life context has not been well-established *** To test the accuracy of CEUS LI-RADS for correctly diagnosing HCC and ICC in *** CEUS LI-RADS class was retrospectively assigned to 511 nodules identified in 269 patients suffering from liver *** diagnostic standard for all nodules was either biopsy(102 nodules)or CT/MRI(409 nodules).Common diagnostic accuracy indexes such as sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NPV)were assessed for the following associations:CEUS LR-5 and HCC;CEUS LR-4 and 5 merged class and HCC;CEUS LR-M and ICC;and CEUS LR-3 and *** frequency of malignant lesions in CEUS LR-3 subgroups with different CEUS patterns was also ***-rater agreement for CEUS LI-RADS class assignment and for major CEUS pattern identification was *** CEUS LR-5 predicted HCC with a 67.6%sensitivity,97.7%specificity,and 99.3%PPV(P<0.001).The merging of LR-4 and 5 offered an improved 93.9%sensitivity in HCC diagnosis with a 94.3%specificity and 98.8%PPV(P<0.001).CEUS LR-M predicted ICC with a 91.3%sensitivity,96.7%specificity,and 99.6%NPV(P<0.001).CEUS LR-3 predominantly included benign lesions(only 28.8%of malignancies).In this class,the hypo-hypo pattern showed a much higher rate of malignant lesions(73.3%)than the iso-iso pattern(2.6%).Inter-rater agreement between internal raters for CEUS-LR class assignment was almost perfect(n=511,k=0.94,P<0.001),while the agreement among raters from separate centres was subst

关键词： contrast-enhanced ultrasound Liver Imaging Reporting and Data System Hepatocellular carcinoma Intrahepatic cholangiocarcinoma Cirrhosis contrast-enhanced ultrasound Liver

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contrast-enhanced ultrasound in portal venous system aneurysms: A multi-center study

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World Journal of Gastroenterology 2014年第48期20卷 18375-18383页

作者： Claudio Tana Christoph F Dietrich Radu Badea Liliana Chiorean Vincenzo Carrieri Cosima Schiavone Unit of Internistic ultrasound Department of Medicine and Science of Aging "G. d’Annunzio" University 66100 Chieti Italy Internal Medicine Unit Guastalla Hospital 42122 AUSL Reggio Emilia Italy Med Klinik 2 Caritas-Krankenhaus D-97980 Bad Mergentheim Germany Department of Ultrasonography "Octavian Fodor" Institute of Gastroenterology and Hepatology "Iuliu Hatieganu" University of Medicine and Pharmacy 400162 Cluj-Napoca Romania Department of Radiology and Computed Tomography "Octavian Fodor" Institute of Gastroenterology and Hepatology 400162 Cluj-Napoca Romania

AIM: To investigate contrast-enhanced ultrasound (CEUS) findings in portal venous system aneurysms (PVSAs).

关键词： Venous system Portal vein Aneurysm contrast-enhanced ultrasound Computed tomography Magnetic resonance imaging

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contrast-enhanced ultrasound manifestations of synchronous combined hepatocellular-cholangiocarcinoma and hepatocellular carcinoma:A case report

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World Journal of Clinical Cases 2022年第11期10卷 3615-3623页

作者： Ling Gao Jia-Yan Huang Zi-Jian Lu Qiang Lu Department of ultrasound West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina Department of ultrasound Chengdu BOE hospitalChengdu 610219Sichuan ProvinceChina Department of Pathology West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina

BACKGROUND Synchronous combined hepatocellular-cholangiocarcinoma(CHC)and hepatocellular carcinoma(HCC)is very rare,with few literature reports and poor clinical outcomes associated with the *** resection is the main treatment,which makes the preoperative diagnosis very ***,due to imaging manifestations overlapping with HCC,diagnosis of this type of synchronous cancer is challenging and it tends to be misdiagnosed as multiple ***,we report the contrast-enhanced ultrasound(CEUS)manifestations of a case of synchronous CHC and HCC,aiming at adding to the understanding of this *** displayed exquisite vascularity and tissue perfusion in real time with good spatial and temporal resolution and more accurately reflect tumor washin and washout times than contrast-enhanced computed tomography(CT)in this *** SUMMARY The patient was a 69-year-old female with a 20-year history of chronic hepatitis *** to months of epigastric pain and anorexia,she reffered to our hospital for *** days before hospitalization,abdominal magnetic resonance imaging performed at another hospital detected a space-occupying lesion in the *** her hospitalization,laboratory tests showed elevated alpha-fetoprotein and carbohydrate antigen 19-9 *** suspicious liver lesions located in S4 and S6,respectively,were identified in a cirrhotic background by abdominal contrast-enhanced CT(CECT).Furthermore,the lesion in S4 and S6 were detected by CEUS and assigned to CEUS LI-RADS 5 and M categories,*** patient underwent tumor radical ***-operative pathology confirmed the S4 and S6 lesions to be HCC and CHC,respectively.A newly-found suspicious liver nodule with potential malignancy was detected in liver S1 by both CEUS and CECT 7 mo after *** The CEUS characteristics of CHC and HCC are *** features in combination with clinical information could help in effective diagnosis,clinical decisio

关键词： contrast-enhanced ultrasound Synchronous dual primary malignancies of liver Combined hepatocellular and cholangiocarcinoma Hepatocellular carcinoma Case report

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contrast-enhanced ultrasound using SonoVue mixed with oral gastrointestinal contrast agent to evaluate esophageal hiatal hernia: Report of three cases and a literature review

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World Journal of Clinical Cases 2021年第11期9卷 2679-2687页

作者： Jing-Yu Wang Yan Luo Wen-Ying Wang Shi-Cheng Zheng Lian He Chun-Yan Xie Li Peng Department of ultrasound First People's Hospital of Longquanyi DistrictLongquan Hospital of West China Hospital of Sichuan UniversityChengdu 610100Sichuan ProvinceChina Department of ultrasound West China Hospital of Sichuan UniversityChengdu 610041Sichuan ProvinceChina Department of Gastroenterology First People's Hospital of Longquanyi DistrictLongquan Hospital of West China Hospital of Sichuan UniversityChengdu 610100Sichuan ProvinceChina

BACKGROUND Due to a thicker abdominal wall in some patients,ultrasound artifacts from gastrointestinal gas and surrounding tissues can interfere with routine ultrasound examination,precluding its ability to display or clearly show the structure of a hernial sac(HS)and thereby diminishing diagnostic performance for esophageal hiatal hernia(EHH).contrast-enhanced ultrasound(CEUS)imaging using an oral agent mixture allows for clear and intuitive identification of an EHH sac and dynamic observation of esophageal *** SUMMARY In this case series,we report three patients with clinically-suspected EHH,including two females and one male with an average age of 67.3±16.4 *** was administered with an oral agent mixture(microbubble-based SonoVue and gastrointestinal contrast agent)and identified a direct sign of supradiaphragmatic HS(containing the hyperechoic agent)and indirect signs[e.g.,widening of esophageal hiatus,hyperechoic mixture agent continuously or intermittently reflux flowing back and forth from the stomach into the supradiaphragmatic HS,and esophagus-gastric echo ring(i.e.,the“EG”ring)seen above the diaphragm].All three cases received a definitive diagnosis of EHH by esophageal manometry and *** lesions resolved upon drug treatment and one required *** recurrence rate in follow-up was 0%.The data from these cases suggest that the new non-invasive examination method may greatly improve the diagnosis of *** CEUS with the oral agent mixture can facilitate clear and intuitive identification of HS and dynamic observation of esophageal reflux.

关键词： SonoVue Oral gastrointestinal contrast agent contrast-enhanced ultrasound Gastrointestinal Hiatal hernia Case report

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contrast-enhanced ultrasound in association with serum biomarkers for differentiating combined hepatocellular-cholangiocarcinoma from hepatocellular carcinoma and intrahepatic cholangiocarcinoma

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World Journal of Gastroenterology 2020年第46期26卷 7325-7337页

作者： Jie Yang Ya-han Zhang Jia-Wu Li Ying-Yu Shi Jia-Yan Huang Yan Luo Ji-Bin Liu Qiang Lu Department of Medical ultrasound West China Hospital of Sichuan UniversityChengdu 610041Sichuan ProvinceChina Department of Pathology West China Hospital of Sichuan UniversityChengdu 610041Sichuan ProvinceChina Department of Radiology Thomas Jefferson UniversityPhiladelphiaPA 19107United States

BACKGROUND Combined hepatocellular-cholangiocarcinoma(CHC)is a rare type of primary liver *** to its complex histopathological characteristics,the imaging features of CHC can overlap with those of hepatocellular carcinoma(HCC)and intrahepatic cholangiocarcinoma(ICC).AIM To investigate the possibility and efficacy of differentiating CHC from HCC and ICC by using contrast-enhanced ultrasound(CEUS)Liver Imaging Reporting and Data System(LI-RADS)and tumor *** Between January 2016 and December 2019,patients with histologically confirmed CHC,ICC and HCC with chronic liver disease were *** diagnostic formula for CHC was as follows:(1)LR-5 or LR-M with elevated alphafetoprotein(AFP)and carbohydrate antigen 19-9(CA19-9);(2)LR-M with elevated AFP and normal CA19-9;or(3)LR-5 with elevated CA19-9 and normal *** sensitivity,specificity,accuracy and area under the receiver operating characteristic curve were calculated to determine the diagnostic value of the *** After propensity score matching,134 patients(mean age of 51.4±9.4 years,108 men)were enrolled,including 35 CHC,29 ICC and 70 HCC *** on CEUS LI-RADS classification,74.3%(26/35)and 25.7%(9/35)of CHC lesions were assessed as LR-M and LR-5,*** rates of elevated AFP and CA19-9 in CHC patients were 51.4%and 11.4%,respectively,and simultaneous elevations of AFP and CA19-9 were found in 8.6%(3/35)of CHC *** sensitivity,specificity,positive predictive value,negative predictive value,accuracy and area under the receiver operating characteristic curve of the aforementioned diagnostic criteria for discriminating CHC from HCC and ICC were 40.0%,89.9%,58.3%,80.9%,76.9%and 0.649,*** considering the reported prevalence of CHC(0.4%-14.2%),the positive predictive value and NPV were revised to 1.6%-39.6%and 90.1%-99.7%,*** CHCs are more likely to be classified as LR-M than LR-5 by CEUS *** combination of the CEUS LI-R

关键词： Combined hepatocellular-cholangiocarcinoma contrast-enhanced ultrasound Liver imaging reporting and data system Sensitivity Diagnosis Liver neoplasms

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