Kakegawa Tatsuya, Sugimoto Katsutoshi, Kamiyama Naohisa, Hashimoto Hiroshi, Takahashi Hiroshi, Wada Takuya, Yoshimasu Yu, Takeuchi Hirohito, Nakayama Ryohei, Sakamaki Kentaro, Itoi Takao
Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
Ultrasound General Imaging, GE HealthCare, Tokyo, Japan.
Ultrasonography. 2024 Nov;43(6):457-468. doi: 10.14366/usg.24100. Epub 2024 Aug 5.
The study aimed to compare the diagnostic performance of washout-parametric imaging (WOPI) with that of conventional contrast-enhanced ultrasound (cCEUS) in differentiating focal liver lesions (FLLs).
A total of 181 FLLs were imaged with contrast-enhanced ultrasound using Sonazoid, and the recordings were captured for 10 minutes in a prospective setting. WOPI was constructed from three images, depicting the arterial phase (peak enhancement), the early portal venous phase (1-minute post-injection), and the vasculo-Kupffer phase (5 or 10 minutes post-injection). The intensity variations in these images were color-coded and superimposed to produce a single image representing the washout timing across the lesions. From the 181 FLLs, 30 hepatocellular carcinomas (HCCs), 30 non-HCC malignancies, and 30 benign lesions were randomly selected for an observer study. Both techniques (cCEUS and WOPI) were evaluated by four off-site readers. They classified each lesion as benign or malignant using a continuous rating scale, with the endpoints representing "definitely benign" and "definitely malignant." The diagnostic performance of cCEUS and WOPI was compared using the area under the receiver operating characteristic curve (AUC) with the DeLong test. Interobserver agreement was assessed using the intraclass correlation coefficient (ICC).
The difference in average AUC values between WOPI and cCEUS was 0.0062 (95% confidence interval, -0.0161 to 0.0285), indicating no significant difference between techniques. The interobserver agreement was higher for WOPI (ICC, 0.77) than cCEUS (ICC, 0.67).
The diagnostic performance of WOPI is comparable to that of cCEUS in differentiating FLLs, with superior interobserver agreement.
本研究旨在比较洗脱参数成像（WOPI）与传统对比增强超声（cCEUS）在鉴别肝脏局灶性病变（FLLs）方面的诊断性能。
使用声诺维对181个FLLs进行对比增强超声成像，并在前瞻性研究中记录10分钟。WOPI由三张图像构建而成，分别描绘动脉期（峰值增强）、早期门静脉期（注射后1分钟）和血管-库普弗细胞期（注射后5或10分钟）。对这些图像中的强度变化进行颜色编码并叠加，以生成一张代表病变洗脱时间的单一图像。从181个FLLs中随机选取30个肝细胞癌（HCCs）、30个非HCC恶性肿瘤和30个良性病变进行观察者研究。由四位非现场阅片者对两种技术（cCEUS和WOPI）进行评估。他们使用连续评分量表将每个病变分类为良性或恶性，端点分别代表“肯定良性”和“肯定恶性”。使用接受者操作特征曲线下面积（AUC）和德龙检验比较cCEUS和WOPI的诊断性能。使用组内相关系数（ICC）评估观察者间的一致性。
WOPI和cCEUS的平均AUC值差异为0.0062（95%置信区间，-0.0161至0.0285），表明两种技术之间无显著差异。WOPI的观察者间一致性（ICC，0.77）高于cCEUS（ICC，0.67）。
在鉴别FLLs方面，WOPI的诊断性能与cCEUS相当，且观察者间一致性更高。
