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Diagnosis of intrahepatic cholangiocarcinoma with CEUS

Giancarlo Gismondo Velardi
Giancarlo Gismondo Velardi
, 
Matilde Lico
Matilde Lico
, 
Angela Teti
Angela Teti
, 
Rosario Maccarone
Rosario Maccarone
, 
Giuseppe Casuscelli
Giuseppe Casuscelli
, 
Letterio Militano
Letterio Militano
, 
Ilaria Vittoria Trecroci
Ilaria Vittoria Trecroci
, 
Maria Mendicino
Maria Mendicino
, 
Antonello Parlati
Antonello Parlati
, 
Adele De Caridi
Adele De Caridi
, 
Giuseppe Loria
Giuseppe Loria
, 
Saverio Loria
Saverio Loria
, 
Sveva Loria
Sveva Loria
, 
Denise Gambardella
Denise Gambardella
, 
Manfredo Tedesco
Manfredo Tedesco
, 
Francesca Frosina
Francesca Frosina
, 
Pierluigi Falco
Pierluigi Falco
 and 
Francesco Loria
Francesco Loria
   | Feb 27, 2024
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Article Category: Review paper
Published Online: Feb 27, 2024
Page range: -
Received: Jul 21, 2023
Accepted: Aug 23, 2023
DOI: https://doi.org/10.15557/jou.2024.0005
Keywords
© 2024 Giancarlo Gismondo Velardi et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Fig. 1.

A. B-Mode ultrasound shows slightly hyperechogenic, inhomogeneous ecostructure nodule with slightly rough and irregular hypoechoic margins; B. Arterial phase (20 s): rim-like peripheral hyperenhancement with central microcirculation; C. Portal phase (70 s): the nodule has peripheral wash-out with central hypoenhancement; D. Late phase: ICC nodule presenting hypoenhancement
A. B-Mode ultrasound shows slightly hyperechogenic, inhomogeneous ecostructure nodule with slightly rough and irregular hypoechoic margins; B. Arterial phase (20 s): rim-like peripheral hyperenhancement with central microcirculation; C. Portal phase (70 s): the nodule has peripheral wash-out with central hypoenhancement; D. Late phase: ICC nodule presenting hypoenhancement

Fig. 2.

A. B-Mode ultrasound shows an unevenly hypoechoic nodule at finely drafted irregular margins, showing no intralesional vascularization at color-Doppler; B. Arterial phase (22 s); C. Portal phase (65 s): slight persistence of peripheral enhancement with intralesional contrast agent wash-out; D: Late phase: nodule hypoenhancement
A. B-Mode ultrasound shows an unevenly hypoechoic nodule at finely drafted irregular margins, showing no intralesional vascularization at color-Doppler; B. Arterial phase (22 s); C. Portal phase (65 s): slight persistence of peripheral enhancement with intralesional contrast agent wash-out; D: Late phase: nodule hypoenhancement

Fig. 3.

A. B-Mode ultrasound shows a homogenous isohypoechoic nodule with thin peripheral hypoechoic capsule; B. Arterial phase (17 s): complete and homogeneous hyperenhancement of the nodule; nodule presents in portal phase (C, 70 s) and late (D) hypoenhancement
A. B-Mode ultrasound shows a homogenous isohypoechoic nodule with thin peripheral hypoechoic capsule; B. Arterial phase (17 s): complete and homogeneous hyperenhancement of the nodule; nodule presents in portal phase (C, 70 s) and late (D) hypoenhancement

Fig. 4.

CEUS in a typical HCC. A. B-Mode ultrasound shows an isohyperechoic nodule (arrow); B. Arterial phase (30 s): complete and homogeneous hyperenhancement of the nodule (arrow); C. In the portal phase (90 s), the nodule appears slightly hypovascular (arrow); D. In the late phase (180 s), the nodule appears completely hypovascular (arrow)
CEUS in a typical HCC. A. B-Mode ultrasound shows an isohyperechoic nodule (arrow); B. Arterial phase (30 s): complete and homogeneous hyperenhancement of the nodule (arrow); C. In the portal phase (90 s), the nodule appears slightly hypovascular (arrow); D. In the late phase (180 s), the nodule appears completely hypovascular (arrow)

Fig. 5.

A. B-Mode ultrasound shows a circumscribed isodense polypoid overhang in the context of the biliary intrahepatic pathway at the seventh segment (arrow); B. In the arterial phase, there is a partial capsular peripheral enhancement (arrow); C. In the portal phase, the intraductal ICC nodule presents tenuous hyperenhancement (arrow); D. In the late phase, the nodule presents hypoenhancement (arrow)
A. B-Mode ultrasound shows a circumscribed isodense polypoid overhang in the context of the biliary intrahepatic pathway at the seventh segment (arrow); B. In the arterial phase, there is a partial capsular peripheral enhancement (arrow); C. In the portal phase, the intraductal ICC nodule presents tenuous hyperenhancement (arrow); D. In the late phase, the nodule presents hypoenhancement (arrow)

Sensitivity, specificity, diagnostic accuracy, and positive and negative predictive values in the diagnosis of ICC by CEUS. Review of recent literature

Author Sensitivity Specificity Diagnostic accuracy PPV NPV
Vidili et al. (2022)(48) 91.3% 96.7% 96.5% 56.8% 99.6%
Dong et al. (2023)(19) 86.7% 95.8% 90.7% – –
Ainora et al. (2023)(18) 80% 83.8% – 82.3% 81.6%
Li et al. (2014)(40) 78.8% 88% 84.3% 81.3% 86.3%

Sensitivity, specificity, diagnostic accuracy, and positive and negative predictive values in the diagnosis of ICC by CT and MRI. Review of recent literature

Author Sensitivity Specificity Diagnostic accuracy PPV NPV
Li et al. (2022)(49)

CT: 79.4%

MRI: 84.1%

CT: 67.1%

MRI: 65.7%

 – – –
Lee et al. (2010)(50) CT: 84.2% CT: 70.6% CT: 81.8% CT: 93.2% CT: 48%
Kim et al. (2021)(51)

CT: 83.4%

MRI: 83.4%

CT: 96.4%

MRI: 97.6%

CT: 89.8%

MRI: 90.4%

 – –
Nisioka et al. (2022)(52)

CT: 49%

MRI: 51%

CT: 100%

MRI: 97%

CT: 80%

MRI: 79%

CT: 100%

MRI: 92%

CT: 75%

MRI: 76%
Petrowsky et al. (2006)(53) CT: 78% CT: 80% CT: 79% CT: 92% CT: 57%
Ke et al. (2023)(54)

CT: 60.98%

MRI: 95.12%

CT: 76.92%

MRI: 96.15%

CT: 69.89%

MRI: 95.7%

 – –
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Language:
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