Contrast-enhanced US of High-Risk Indeterminate Focal Liver Observations Categorized as LR-4 or LR-M at CT/MRI

Andrej Lyshchik; Cristina Kuon-Yeng; Tania Siu Xiao; Fabio Piscaglia; Yuko Kono; Alexandra Medellin-Kowalewski; Shuchi K. Rodgers; Virginia B. Planz; Aya Kamaya; David T. Fetzer; Annalisa Berzigotti; Iuliana-Pompilia Radu; Paul S. Sidhu; Corinne E. Wessner; Kristen Bradigan; John R. Eisenbrey; Flemming Forsberg; Stephanie R. Wilson; Gibran Yusuf; Abid Suddle; Vasileios Rafailidis; Lorenzo Mulazzani; Alessandro Granito; Eleonora Terzi; A. Forgione; Alice Giamperoli; Bernardo Stefanini; Lisa Finch; Amit G. Singal

doi:10.1148/radiol.240916

Key Points

To assess the diagnostic utility and clinical impact of contrast-enhanced ultrasound for characterizing high-risk indeterminate focal liver observations classified as LR-4 or LR-M on CT or MRI.
Interventional clinical trial (ClinicalTrials.gov: NCT03318380) evaluating contrast-enhanced ultrasound (CEUS) for indeterminate focal liver observations (N=68).
Observations previously designated as LR-4 or LR-M on CT or MRI were re-evaluated with CEUS, with subgroup focus on lesions measuring at least 20 mm.
CEUS correctly categorized indeterminate lesions into LR-5 hepatocellular carcinoma and LR-M non-hepatocellular malignancies.
CEUS led to management recommendation changes in 40% (27 of 68) of observations with 100% accuracy, demonstrating particularly high impact for lesions measuring at least 20 mm.

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Abstract

= 68); CEUS helped appropriately categorize both LR-5 and LR-M lesions as HCC and non-HCC malignancies, respectively, and resulted in management recommendation changes in 40% (27 of 68) of observations with 100% accuracy. Conclusion CEUS resolved some high-risk indeterminate liver observations (categorized as LR-4 and LR-M at CT or MRI), with particularly high clinical impact for observations measuring at least 20 mm. Clinical trial registration no.

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Lyshchik et al. (2025) studied this question.

synapsesocial.com/papers/6aa4469b22af0bded4f43d18 https://doi.org/10.1148/radiol.240916

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Contrast-enhanced US of High-Risk Indeterminate Focal Liver Observations Categorized as LR-4 or LR-M at CT/MRI

Key Points

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Abstract

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Cite This Study

Contrast-enhanced US of High-Risk Indeterminate Focal Liver Observations Categorized as LR-4 or LR-M at CT/MRI

Key Points

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Abstract

Discussion

Cite This Study

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