Investigative Radiology

Skip Navigation LinksHome > February 2011 - Volume 46 - Issue 2 > Indeterminate Focal Liver Lesions Incidentally Discovered at...
Investigative Radiology:
doi: 10.1097/RLI.0b013e3181f44184
Original Article

Indeterminate Focal Liver Lesions Incidentally Discovered at Gray-Scale US: Role of Contrast-Enhanced Sonography

Bartolotta, Tommaso Vincenzo MD, PhD*; Taibbi, Adele MD*; Midiri, Massimo MD*; Matranga, Domenica PhD*; Solbiati, Luigi MD†; Lagalla, Roberto MD*

Collapse Box


Objectives: To assess the role of contrast-enhanced ultrasound (CEUS) in the characterization of focal liver lesions (FLLs) incidentally discovered but indeterminate at gray-scale ultrasound (US).

Materials and Methods: One hundred forty-two consecutive patients with 174 FLLs (169 benign and 5 malignant) incidentally discovered but indeterminate at gray-scale US, underwent CEUS after the administration of SonoVue. Two readers independently reviewed CEUS scans and: (1) classified each lesion as malignant or benign on a 5-point scale of confidence by means of definite diagnostic criteria; (2) provided if possible a specific diagnosis; (3) were requested if further imaging was needed for lesion characterization. Sensitivity, specificity, and areas under the receiver-operating characteristic curve (Az) as well as interobserver agreement were calculated.

Results: At CEUS, both readers correctly differentiated benign from malignant lesions in 168 of 174 (96.5%) cases (P < 0.0001). A specific correct diagnosis was provided in 123 of 174 (70.7%) and 127 of 174 (72.9%) cases for reader 1 and 2, respectively (P < 0.0001). A further imaging study to characterize the lesion after CEUS was requested in 67 cases (38.5%) for reader 1 (P < 0.001) and 46 cases (26.4%) for reader 2 (P < 0.001). Receiver-operating characteristic analysis after CEUS revealed Az value of 1 for both readers and sensitivity and specificity values of 100% and 97.04% for reader 1 and 100% and 96.45 for reader 2 respectively (P < 0.0001). Inter-reader agreement at CEUS was good (weighted k = 0.779).

Conclusion: CEUS improves the diagnostic performance of radiologists in the characterization of indeterminate FLLs incidentally discovered at US and reduces the need for further radiologic work-up.

© 2011 Lippincott Williams & Wilkins, Inc.


Article Tools


Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.