Retrospective analysis to assess the diagnostic value and accuracy for characterisation of focal lesions with contrast enhanced ultrasound (CEUS) 

Sarah Carpenter, Ben Stenberg, Andrew McNeil, Naail Al-Zuhir, Elisabeth Pearce, Freeman Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust

Objectives

Contrast enhanced ultrasound (CEUS) was developed to overcome the limitations of conventional Doppler & B-mode ultrasound and to utilise the enhancement characteristics of focal liver lesion which are more traditionally assessed using CT and MRI.  In recent years, there has been significant experience gained as well as technological improvements, in this technique.  The aim of this study was to assess the local diagnostic accuracy for characterisation of focal lesions using (CEUS) by comparing the findings of those on CT/MRI & histology. 

Methods

A retrospective analysis was carried out of all patients in the authors’ centre who had CEUS studies to characterise focal liver lesions.  These studies were performed between January 2014 & December 2016. The CEUS results were compared to the findings from tissue diagnosis and CT/MRI characterisation.

Results

A total of 333 CEUS studies were analysed – 291 of these offered a definitive diagnosis, (192 benign lesions and 109 malignant lesions were identified.)  125 of the 291 conclusive studies had further subsequent histological and radiological characterisation (CT+MRI).  The positive predictive value = 90% and the negative predictive value = 95%, with a sensitivity of the CEUS findings concurring with further imaging and histology of 97% and a specificity was 84%. 

Conclusion

In this study, CEUS demonstrated an excellent specificity and sensitivity for the detected of focal lesions. CEUS, when technically feasible, can be used as a surrogate for CECT and CEMRI in the assessment of focal liver lesions and it can play a fundamental role in their identification and characterisation reducing the need for re-appointment, delays and specialist referral.   CEUS offers a highly cost-effective option for the characterisation of straight forward lesions such as haemangiomas. 

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