Skip to main content

Ultrasound of Hepatocellular Carcinoma: The Important Contribution of Contrast Enhancement

  • Chapter
  • First Online:
Hepatocellular Carcinoma

Part of the book series: Current Clinical Oncology ((CCO))

Abstract

The noninvasive diagnosis of hepatocellular carcinoma (HCC) relies heavily on imaging-based primarily on sequential changes in the intranodular blood supply during the process of hepatocarcinogenesis.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Matsui O. Detection and characterization of hepatocellular carcinoma by imaging. Clin Gastroenterol Hepatol. 2005;3:S136–40.

    Article  PubMed  Google Scholar 

  2. Choi BI, Lee JM, Kim TK, et al. Diagnosing borderline hepatic nodules in hepatocarcinogenesis: imaging performance. AJR Am J Roentgenol. 2015;205:10–21.

    Article  PubMed  Google Scholar 

  3. Bruix J, Sherman M, American Association for the Study of Liver D. Management of hepatocellular carcinoma: an update. Hepatology. 2011;53:1020–22.

    Google Scholar 

  4. European Association for the Study of the L, European Organisation for R and Treatment of C. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol. 2012;56:908–43.

    Article  Google Scholar 

  5. Omata M, Lesmana LA, Tateishi R, et al. Asian Pacific Association for the study of the liver consensus recommendations on hepatocellular carcinoma. Hepatol Int. 2010;4:439–74.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Khalili K, Kim TK, Jang HJ, et al. Optimization of imaging diagnosis of 1–2 cm hepatocellular carcinoma: an analysis of diagnostic performance and resource utilization. J Hepatol. 2011;54:723–8.

    Article  PubMed  Google Scholar 

  7. Lanka B, Jang HJ, Kim TK, et al. Impact of contrast-enhanced ultrasonography in a tertiary clinical practice. J Ultrasound Med. 2007;26:1703–14.

    PubMed  Google Scholar 

  8. Raza SA, Jang HJ, Kim TK. Differentiating malignant from benign thrombosis in hepatocellular carcinoma: contrast-enhanced ultrasound. Abdom Imaging. 2014;39:153–61.

    Article  PubMed  Google Scholar 

  9. Brannigan M, Burns PN, Wilson SR. Blood flow patterns in focal liver lesions at microbubble-enhanced US. Radiographics. 2004;24:921–35.

    Article  PubMed  Google Scholar 

  10. Korenaga K, Korenaga M, Furukawa M, et al. Usefulness of sonazoid contrast-enhanced ultrasonography for hepatocellular carcinoma: comparison with pathological diagnosis and superparamagnetic iron oxide magnetic resonance images. J Gastroenterol. 2009;44:733–41.

    Article  PubMed  Google Scholar 

  11. Piscaglia F, Bolondi L. The safety of sonovue in abdominal applications: retrospective analysis of 23188 investigations. Ultrasound Med Biol. 2006;32:1369–75.

    Article  PubMed  Google Scholar 

  12. Wilson SR, Jang HJ, Kim TK, et al. Real-time temporal maximum-intensity-projection imaging of hepatic lesions with contrast-enhanced sonography. AJR Am J Roentgenol. 2008;190:691–5.

    Article  PubMed  Google Scholar 

  13. Nicolau C, Catala V, Vilana R, et al. Evaluation of hepatocellular carcinoma using SonoVue, a second generation ultrasound contrast agent: correlation with cellular differentiation. Eur Radiol. 2004;14:1092–9.

    Article  PubMed  Google Scholar 

  14. Quaia E, Calliada F, Bertolotto M, et al. Characterization of focal liver lesions with contrast-specific US modes and a sulfur hexafluoride-filled microbubble contrast agent: diagnostic performance and confidence. Radiology. 2004;232:420–30.

    Article  PubMed  Google Scholar 

  15. Wilson SR, Burns PN. An algorithm for the diagnosis of focal liver masses using microbubble contrast-enhanced pulse-inversion sonography. AJR Am J Roentgenol. 2006;186:1401–12.

    Article  PubMed  Google Scholar 

  16. Numata K, Fukuda H, Nihonmatsu H, et al. Use of vessel patterns on contrast-enhanced ultrasonography using a perflubutane-based contrast agent for the differential diagnosis of regenerative nodules from early hepatocellular carcinoma or high-grade dysplastic nodules in patients with chronic liver disease. Abdom Imaging. 2015;40:2372–83.

    Article  PubMed  Google Scholar 

  17. Wilson SR, Kim TK, Jang HJ, et al. Enhancement patterns of focal liver masses: discordance between contrast-enhanced sonography and contrast-enhanced CT and MRI. AJR Am J Roentgenol. 2007;189:W7–12.

    Article  PubMed  Google Scholar 

  18. Maruyama H, Takahashi M, Ishibashi H, et al. Contrast-enhanced ultrasound for characterisation of hepatic lesions appearing non-hypervascular on CT in chronic liver diseases. Br J Radiol. 2012;85:351–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Takahashi M, Maruyama H, Shimada T, et al. Characterization of hepatic lesions (</=30 mm) with liver-specific contrast agents: a comparison between ultrasound and magnetic resonance imaging. Eur J Radiol. 2013;82:75–84.

    Article  PubMed  Google Scholar 

  20. Bhayana D, Kim TK, Jang HJ, et al. Hypervascular liver masses on contrast-enhanced ultrasound: the importance of washout. AJR Am J Roentgenol. 2010;194:977–83.

    Article  PubMed  Google Scholar 

  21. Han J, Liu Y, Han F, et al. The degree of contrast washout on contrast-enhanced ultrasound in distinguishing intrahepatic cholangiocarcinoma from hepatocellular carcinoma. Ultrasound Med. Biol. 2015;41(12):3088–95.

    Google Scholar 

  22. Jang HJ, Kim TK, Burns PN, et al. CEUS: an essential component in a multimodality approach to small nodules in patients at high-risk for hepatocellular carcinoma. Eur J Radiol. 2015;84:1623–35.

    Article  PubMed  Google Scholar 

  23. Jang HJ, Kim TK, Burns PN, et al. Enhancement patterns of hepatocellular carcinoma at contrast-enhanced US: comparison with histologic differentiation. Radiology. 2007;244:898–906.

    Article  PubMed  Google Scholar 

  24. Jang HJ, Kim TK, Wilson SR. Small nodules (1–2 cm) in liver cirrhosis: characterization with contrast-enhanced ultrasound. Eur J Radiol. 2009;72:418–24.

    Article  PubMed  Google Scholar 

  25. Vilana R, Forner A, Bianchi L, et al. Intrahepatic peripheral cholangiocarcinoma in cirrhosis patients may display a vascular pattern similar to hepatocellular carcinoma on contrast-enhanced ultrasound. Hepatology. 2010;51:2020–9.

    Article  PubMed  Google Scholar 

  26. Li R, Yuan MX, Ma KS, et al. Detailed analysis of temporal features on contrast enhanced ultrasound may help differentiate intrahepatic cholangiocarcinoma from hepatocellular carcinoma in cirrhosis. PLoS ONE. 2014;9:e98612.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Yin X, Zhang BH, Qiu SJ, et al. Combined hepatocellular carcinoma and cholangiocarcinoma: clinical features, treatment modalities, and prognosis. Ann Surg Oncol. 2012;19:2869–76.

    Article  PubMed  Google Scholar 

  28. Kim TK, Choi BI, Han JK, et al. Peripheral cholangiocarcinoma of the liver: two-phase spiral CT findings. Radiology. 1997;204:539–43.

    Article  CAS  PubMed  Google Scholar 

  29. Lim JH, Cho JM, Kim EY, et al. Dysplastic nodules in liver cirrhosis: evaluation of hemodynamics with CT during arterial portography and CT hepatic arteriography. Radiology. 2000;214:869–74.

    Article  CAS  PubMed  Google Scholar 

  30. Khalili K, Kim TK, Jang HJ, et al. Indeterminate 1–2-cm nodules found on hepatocellular carcinoma surveillance: biopsy for all, some, or none? Hepatology. 2011;54:2048–54.

    Article  PubMed  Google Scholar 

  31. Kim TK, Lee KH, Jang HJ, et al. Analysis of gadobenate dimeglumine-enhanced MR findings for characterizing small (1–2-cm) hepatic nodules in patients at high risk for hepatocellular carcinoma. Radiology. 2011;259:730–8.

    Article  PubMed  Google Scholar 

  32. Caturelli E, Pompili M, Bartolucci F, et al. Hemangioma-like lesions in chronic liver disease: diagnostic evaluation in patients. Radiology. 2001;220:337–42.

    Article  CAS  PubMed  Google Scholar 

  33. Kim TK, Jang HJ. Contrast-enhanced ultrasound in the diagnosis of nodules in liver cirrhosis. World J Gastroenterol. 2014;20:3590–6.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Kim TK, Jang HJ, Wilson SR. Benign liver masses: imaging with microbubble contrast agents. Ultrasound Q. 2006;22:31–9.

    PubMed  Google Scholar 

  35. Kim TK, Choi BI, Han JK, et al. Nontumorous arterioportal shunt mimicking hypervascular tumor in cirrhotic liver: two-phase spiral CT findings. Radiology. 1998;208:597–603.

    Article  CAS  PubMed  Google Scholar 

  36. Yu JS, Kim KW, Jeong MG, et al. Nontumorous hepatic arterial-portal venous shunts: MR imaging findings. Radiology. 2000;217:750–6.

    Article  CAS  PubMed  Google Scholar 

  37. Barreiros AP, Piscaglia F, Dietrich CF. Contrast enhanced ultrasound for the diagnosis of hepatocellular carcinoma (HCC): comments on AASLD guidelines. J Hepatol. 2012;57:930–2.

    Article  PubMed  Google Scholar 

  38. Mitchell DG, Bruix J, Sherman M, et al. LI-RADS (liver imaging reporting and data system): summary, discussion, and consensus of the LI-RADS management working group and future directions. Hepatology. 2015;61:1056–65.

    Article  PubMed  Google Scholar 

  39. Sakata J, Shirai Y, Wakai T, et al. Preoperative predictors of vascular invasion in hepatocellular carcinoma. Eur J Surg Oncol (EJSO). 2008;34:900–5.

    Article  CAS  Google Scholar 

  40. Takizawa D, Kakizaki S, Sohara N, et al. Hepatocellular carcinoma with portal vein tumor thrombosis: clinical characteristics, prognosis, and patient survival analysis. Dig Dis Sci. 2007;52:3290–5.

    Article  PubMed  Google Scholar 

  41. Ogren M, Bergqvist D, Bjorck M, et al. Portal vein thrombosis: prevalence, patient characteristics and lifetime risk: a population study based on 23,796 consecutive autopsies. World J Gastroenterol. 2006;12:2115–9.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Lim JH, Auh YH. Hepatocellular carcinoma presenting only as portal venous tumor thrombosis: CT demonstration. J Comput Assist Tomogr. 1992;16:103–6.

    Article  CAS  PubMed  Google Scholar 

  43. Kim TK, Khalili K, Jang HJ. Local ablation therapy with contrast-enhanced ultrasonography for hepatocellular carcinoma: a practical review. Ultrasonography. 2015;34:235–45.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Lee MW. Fusion imaging of real-time ultrasonography with CT or MRI for hepatic intervention. Ultrasonography. 2014;33:227–39.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Dill-Macky MJ, Asch M, Burns P, et al. Radiofrequency ablation of hepatocellular carcinoma: predicting success using contrast-enhanced sonography. AJR Am J Roentgenol. 2006;186:S287–95.

    Article  PubMed  Google Scholar 

  46. Solbiati L, Tonolini M, Cova L. Monitoring RF ablation. Eur Radiol. 2004;14(Suppl 8):P34–42.

    PubMed  Google Scholar 

  47. Catalano O, Esposito M, Nunziata A, et al. Multiphase helical CT findings after percutaneous ablation procedures for hepatocellular carcinoma. Abdom Imaging. 2000;25:607–14.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Stephanie R. Wilson .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Kim, T.K., Jang, HJ., Wilson, S.R. (2016). Ultrasound of Hepatocellular Carcinoma: The Important Contribution of Contrast Enhancement. In: Carr, B. (eds) Hepatocellular Carcinoma. Current Clinical Oncology. Springer, Cham. https://doi.org/10.1007/978-3-319-34214-6_24

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-34214-6_24

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-34212-2

  • Online ISBN: 978-3-319-34214-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics