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      FI-CEUS: a solution to improve the diagnostic accuracy in MRI LI-RADS-indeterminate (LR-3/4) FLLs at risk for HCC

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          Abstract

          Objective

          To evaluate the diagnostic accuracy of fusion imaging contrast-enhanced ultrasound (FI-CEUS) of magnetic resonance imaging (MRI) LI-RADS-indeterminate (LR-3/4) and conventional ultrasound undetected focal liver lesions (FLLs) in patients at risk for hepatocellular carcinoma (HCC).

          Methods

          Between February 2020 and July 2021, 71 FLLs in 63 patients were registered for diagnostic performance evaluation respectively for ultrasound-guided thermal ablation evaluation in this retrospective study. Diagnostic performance regarding FLLs was compared between FI-CEUS and contrast-enhanced MRI (CE-MRI).

          Results

          For diagnostic performance evaluation, among 71 lesions in 63 patients, the diagnostic efficacy of FI-CEUS with LI-RADS was significantly higher than that of CE-MRI ( P < 0.05) in both overall and hierarchical comparison (except for the group with lesion diameter ≥2 cm). For malignant lesions, the proportion of arterial phase hyperenhancement (APHE) and washout on FI-CEUS was higher than that on CE-MRI ( P < 0.05).

          Conclusion

          FI-CEUS has a high value in the precise qualitative diagnosis of small FLLs (<2 cm) of MRI LI-RADS-indeterminate diagnosis (LR-3/4) that are undetected by conventional ultrasound in patients at risk for HCC and can be a good supplementary CE-MRI diagnostic method for thermal ablation evaluation.

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          Most cited references30

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          Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

          This article provides an update on the global cancer burden using the GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer. Worldwide, an estimated 19.3 million new cancer cases (18.1 million excluding nonmelanoma skin cancer) and almost 10.0 million cancer deaths (9.9 million excluding nonmelanoma skin cancer) occurred in 2020. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), followed by lung (11.4%), colorectal (10.0 %), prostate (7.3%), and stomach (5.6%) cancers. Lung cancer remained the leading cause of cancer death, with an estimated 1.8 million deaths (18%), followed by colorectal (9.4%), liver (8.3%), stomach (7.7%), and female breast (6.9%) cancers. Overall incidence was from 2-fold to 3-fold higher in transitioned versus transitioning countries for both sexes, whereas mortality varied <2-fold for men and little for women. Death rates for female breast and cervical cancers, however, were considerably higher in transitioning versus transitioned countries (15.0 vs 12.8 per 100,000 and 12.4 vs 5.2 per 100,000, respectively). The global cancer burden is expected to be 28.4 million cases in 2040, a 47% rise from 2020, with a larger increase in transitioning (64% to 95%) versus transitioned (32% to 56%) countries due to demographic changes, although this may be further exacerbated by increasing risk factors associated with globalization and a growing economy. Efforts to build a sustainable infrastructure for the dissemination of cancer prevention measures and provision of cancer care in transitioning countries is critical for global cancer control.
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            EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma

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              Diagnosis, Staging, and Management of Hepatocellular Carcinoma: 2018 Practice Guidance by the American Association for the Study of Liver Diseases

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                Author and article information

                Contributors
                Journal
                Front Oncol
                Front Oncol
                Front. Oncol.
                Frontiers in Oncology
                Frontiers Media S.A.
                2234-943X
                17 January 2024
                2023
                : 13
                : 1225116
                Affiliations
                [1] 1 Department of Ultrasound, The Third Affiliated Hospital of Sun Yat-sen University , Guangzhou, China
                [2] 2 Department of Radiology, The Third Affiliated Hospital of Sun Yat-sen University , Guangzhou, China
                [3] 3 Department of Ultrasound, The Third Affiliated Hospital of Sun Yat-sen University-Yuedong Hospital , Meizhou, China
                Author notes

                Edited by: Xin-Wu Cui, Huazhong University of Science and Technology, China

                Reviewed by: Xiang Jing, Tianjin Third Central Hospital, China

                Feiqian Wang, The First Affiliated Hospital of Xi’an Jiaotong University, China

                *Correspondence: Kai Li, likai@ 123456mail.sysu.edu.cn

                †These authors have contributed equally to this work and share first authorship

                Article
                10.3389/fonc.2023.1225116
                10828013
                38298440
                154b45c4-32b5-4799-9882-9b661b434f66
                Copyright © 2024 Zeng, Xie, He, Guo, Wu, He, Zhang, Yu, Zheng and Li

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 18 May 2023
                : 28 December 2023
                Page count
                Figures: 3, Tables: 5, Equations: 0, References: 32, Pages: 9, Words: 5105
                Funding
                The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study is supported by the Guangzhou Science and Technology Plan Project (2023A03J0218).
                Categories
                Oncology
                Original Research
                Custom metadata
                Cancer Imaging and Image-directed Interventions

                Oncology & Radiotherapy
                contrast-enhanced ultrasound,contrast-enhanced magnetic resonance imaging,fusion imaging,hepatocellular carcinoma,liver imaging reporting and data system

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