Liver Cancer
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 28, 2005; 11(16): 2402-2407
Published online Apr 28, 2005. doi: 10.3748/wjg.v11.i16.2402
Differentiation between malignant and benign nodules in the liver: Use of contrast C3-MODE technology
Bao-Ming Luo, Yan-Ling Wen, Hai-Yun Yang, Hui Zhi, Bing Ou, Jian-Hong Ma, Jing-Sheng Pan, Xiao-Ning Dai
Bao-Ming Luo, Yan-Ling Wen, Hai-Yun Yang, Hui Zhi, Bing Ou, Jian-Hong Ma, Jing-Sheng Pan, Xiao-Ning Dai, Department of Ultrasound, the Second Affiliated Hospital, Sun Yat-Sen University, 107 Yanjiangxi Road, Guangzhou 510120, Guangdong Province, China
Author contributions: All authors contributed equally to the work.
Supported by the Science Foundation of the Department of Science and Technology of Guangdong Province, No. 2002C30315
Correspondence to: Dr. Yan-Ling Wen, Department of Ultrasound, the Second Affiliated Hospital, Sun Yat-Sen University, 107 Yanjiangxi Rd, Guangzhou 510120, Guangdong Province, China. yanlingwen20@hotmail.com
Telephone: +86-20-8133-2516
Received: July 9, 2004
Revised: July 10, 2004
Accepted: September 19, 2004
Published online: April 28, 2005
Abstract

AIM: To investigate the value of contrast-enhanced C3-MODE technology in differentiating malignant nodules of liver from the benign ones.

METHODS: Forty-six nodules in 36 patients (29 men and 7 women) were studied by contrast-enhanced C3-MODE technology and contrast-enhanced CT in 1 wk before the biopsy or operation. A low MI monitor and a high MI flash imaging were intermittently performed. After the injection of contrast agent, the period from 10 to 30 s and the time later than 100 s were respectively defined as early arterial phase and the late phase. The vascularities of the liver nodules in the two phases were combined for differential diagnosis. Corresponding to the pathological diagnosis, the accuracy, sensitivity and specificity of contrast-enhanced C3-MODE technology were compared to those of contrast-enhanced CT.

RESULTS: By C3-MODE technology, 33 of the 46 liver nodules were demonstrated as defected area in the late phase and were diagnosed as malignant tumors. Of them, 28 with hypervascularity in the early arterial phase were assessed as hepatocellular carcinoma, the other five nodules with rim-like enhancement in the early arterial phase were diagnosed as metastatic tumors. Thirteen nodules were shown as iso or hypervascularity in the late phase as well as centripetal filling in the early arterial phase and we made a diagnosis of hemangioma. Corresponding to the pathological results, the sensitivity, specificity and accuracy of contrast-enhanced C3-MODE technology in differentiating malignant and benign nodules in the liver were 97.0%, 92.3% and 95.7%, respectively. With comparison to those of contrast CT (sensitivity, 94.1%; specificity, 91.7%; accuracy, 93.5%), the difference was not significant.

CONCLUSION: Contrast-enhanced C3-MODE technology can effectively differentiate malignant liver tumors from the benign nodules. It highly agrees diagnostically with the pathology. We suggest that it provides a new approach for differential diagnosis of liver nodules in addition to contrast-enhanced CT.

Keywords: Contrast medium; Harmonic imaging; Hepatic nodule; Ultrasound