Comparing enhancement and washout patterns of hepatic lesions between sonazoid-enhanced ultrasound and contrast-enhanced computed tomography

To compare sonazoid-enhanced ultrasound (SEUS) and contrast-enhanced computed tomography (CECT) enhancement and washout patterns in hepatic lesions. Enhancement and washout patterns on SEUS were compared with those on CECT for 61 lesions. There were 36 hepatocellular carcinomas, three intrahepatic cholangiocarcinomas, three metastatic lesions, eight focal nodular hyperplasias, two angiomyolipomas, and nine undetermined benign lesions. Diagnosis was based on histopathology, or CECT and tumor markers, or findings on 2-year follow-up. All 61 lesions (100%) showed arterial enhancement on both SEUS and CECT. The "washout/no washout" agreement between SEUS and CECT for the 61 lesions was 93.4% (kappa coefficient: 0.816). Of the 42 malignant lesions, 38 lesions (90.5%) showed washout on both SEUS and CECT. The remaining four malignant lesions, of which three lesions contained fibrosis (two intrahepatic cholangiocarcinomas and one scirrhous hepatocellular carcinoma), showed washout on SEUS but not on CECT. For the 19 benign lesions, agreement between SEUS and CECT was 100% (kappa coefficient: 1), with seven lesions showing washout with both methods and 12 lesions showing no washout with both methods. The overall concordance rate between SEUS and CECT was good, but some differences were seen in the washout patterns of malignant lesions.