Time-intensity Curve Analysis of Hepatocellular Carcinoma using Two Contrast-enhanced Ultrasound Methods: Contrast Pulse Sequencing and Contrast Harmonic Imaging

Objectives: To compare the features of the time-intensity curve (TIC) of hepatocellular carcinoma (HCC) by two different contrast-enhanced ultrasound (CEUS) methods: Contrast Pulse Sequencing (CPS) and Contrast Harmonic Imaging (CHI).Methods: This prospective study included 22 HCC lesions. The CPS and CHI (Cadence? technique by Siemens) were performed in random order for each lesion, and the microbubbles were completely cleared between the two methods. The imaging by each method was recorded for 10 minutes. The CEUS video clips were analyzed off-line and the quantitative parameters of time intensity curve were obtained: the peak intensity (PI), time to peak (TTP), washout time (WT), relative value (RV) of intensity and AUC before WT and after WT, and the time of RV ≥15 dB lasted (RLT).Results: Compared with CPS, CHI showed an earlier WT (64.0 ± 17.1 s vs 33.1 ± 7.0 s) of HCC lesions, a lower RV of intensity (36.8 ± 9.4 vs 10.3 ± 5.1) and AUC (1377.2 ± 205.7 vs 227.2 ± 56.7) before WT, but higher RV of intensity (17.8 ± 4.6 vs 32.2 ± 8.6) and AUC (1 124.1 ± 276.4 vs 2 664.1 ± 456.8) after WT, and longer RLT (121.4 ± 49.8 s vs > 150 s).Conclusion: For long later phase observation after washout, CHI is better than CPS, but the observation of rapid perfusion before washout is not comparable to CPS. A combined use of these two methods is recommended based on our research.

Abstract licence: CC BY

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