Neoplasms

Digestive System Diseases

All Conditions

Liver Neoplasms

Hematinics

All Drugs and Chemicals

Liver Extracts

there is no intervention diagnosis or treatment for patients

diagnosis

Jie Yu, Dr

Jie Yu, Doctor

Contrast-enhanced ultrasound (CEUS) substantially improves the potential of ultrasound (US) for the identification and characterization of focal liver lesions (FLLs). Compared to contrasted-enhanced MRI and CT, it has some unique advantages, such as the absence of ionizing radiation, and easy operability and repeatability. However, the efficacy of CEUS in diagnosing liver lesions is challenged by several factors including being highly dependent on doctor's experience, low signal-to-noise ratio, and low interobserver agreement. Therefore, it is a beneficial attempt to construct an intelligent CEUS diagnosis system using digital information technology. This study aims to collect standard data of CEUS cines recordings and develop deep learning model for accurate segmentation, detection and classification of liver lesions.

Radiomics Analysis of Focal Liver Lesions Based on Contrast-Enhanced Ultrasound Imaging

Research on Key Techniques for Intelligent Diagnosis and Ablation Decision-making of Liver Cancer and Evolution by Contrast-enhanced Ultrasound

Area under the receiver operating characteristic (ROC) curve (AUC）

diagnosis specificity of intelligent CEUS analysis

diagnosis sensitivity of intelligent ultrasound analysis

Ping Liang

Prof

Gastrointestinal Neoplasms

Digestive System Neoplasms

Gastrointestinal Diseases

Liver Diseases

Sonazoid as a new generation of ultrasound contrast agent.This study based on the features of Sonazoid specific angiography and his mechanical index, the role of Sonazoidin in the differential diagnosis of benign and malignant focal liver lesions in different liver background was explored

Sonazoid as a new generation of ultrasound contrast agent, was liver specificity (Kupffer cells), macrophages at the very stable period, Kupffer imaging contrast enhancement effect for more than 1 hour, it is mainly used for focal liver lesions of blood vessels and Kupffer phase of ultrasonic imaging, facilitate early detection of small lesions (\< 1 cm). Until now, Sonazoid has been mainly focused on liver focal lesions.

Most liver cancer patients in China are associated with chronic liver disease, and more than 80% of liver disease patients are in advanced stage at the time of treatment. Differential diagnosis is still a challenge for enhanced CT / MRI. About 40% of HCCs lack arterial phase enhancement and 40% - 60% of small lesions do not show elution in venous phase. The existing imaging methods have low sensitivity in detecting small lesions, and it is difficult to detect lesions smaller than 1 cm. Studies have found that the sensitivity of CT and MRI is of 60 - 94.4% and 58.5 - 93% respectively when the tumor diameter is larger than 1 cm. When the tumor diameter is less than 1 cm, the sensitivity of CT and MRI to detect tumors is reduced to 33 - 45% and 33 - 67%, respectively. The diagnostic efficiency of conventional ultrasonography for small lesions, especially in patients with chronic hepatitis B or cirrhosis, is poor. Although the diagnostic efficiency of conventional contrast-enhanced ultrasound in the diagnosis of small lesions with chronic hepatitis B or liver cirrhosis has a certain improvement, there is still a large rate of missed diagnosis. In addition, ordinary ultrasound, conventional contrast-enhanced ultrasound, CT and MRI are very poor in the diagnosis of liver cancer differentiation, especially for highly differentiated liver cancer.

Sonazoid is a second generation ultrasound contrast agent, which is composed of microbubbles containing chemically stable and insoluble Perfluorobutane (PFB) gas and a hard shell of phosphatidylserine sodium (2-3 μ m in diameter) wrapped in the outer layer. These microbubbles can generate stable nonlinear oscillations in a low-power acoustic field and generate echoes at the second harmonic frequency of the transmitted pulse for enhanced contrast harmonic imaging . In addition to the ability of real-time angiography, Sonazoid microbubbles can be engulfed by Kupffer cells in the intrahepatic reticuloendothelial system to produce liver parenchymal imaging Usually 10 minutes after intravenous injection of Sonazoid contrast agent, Kupffer phase image appears, and normal liver parenchyma is enhanced . Therefore, at this stage, malignant lesions with little or no Kupffer cells are clearly demonstrated due to the lack of contrast media. In addition, because Sonazoid microbubbles can resonate without rupture under moderate ultrasonic pressure, Kupffer phase (Kupffer phase) imaging can be stable for more than several hours, which is beneficial to whole liver scanning . Because Sonazoid has the advantages of ultra long time development and good stability, Sonazoid has significant clinical advantages in the diagnosis of small liver cancer lesions, liver cirrhosis background liver cancer and highly differentiated liver cancer.. However, these studies based on Sonazoid are all small sample studies and subjective qualitative differential diagnosis methods, and lack of systematic analysis and research. Therefore, based on the advantages of the new ultrasound contrast agent, using qualitative analysis and quantitative analysis method to collect large samples, systematically explore the standardized diagnosis scheme and diagnostic efficiency of liver cancer with different liver background, which has important clinical significance for early diagnosis, early detection and improving the accuracy of diagnosis of liver cancer.

Prospective Multicenter Study on Clinical Application of Sonazoid in Liver Tumor

Contrast-enhanced Ultrasound in Liver Tumor by Sonazoid

Chinese PLA General Hospital

Department of Interventional Ultrasound

Rare Diseases

Carcinoma

Carcinoma, Hepatocellular

Chronic Graft Versus Host Disease

Contrast enhanced ultrasound guided liver biopsy

Tudor Mocan, MD

Zeno Sparchez, MD, PhD

Tudor Mocan

Ioana Rusu

The main purpose of this study is to compare contrast-enhanced ultrasound guided liver biopsy (CEUS-LB) with conventional ultrasound guided liver biopsy (US-LB) in the diagnosis of liver tumors developed on a background of advanced chronic liver diseases. All patients referred to our department with a CT/MRI diagnosis of hepatic neoplasia will be randomly assigned to either CEUS-LB or US-LB. All LB will be performed by the same investigator. For the randomisation the flip coin technique will be used. One investigator without access to previous C/MRI/US report will do the randomization

A prospective parallel group clinical trial will be performed. The study protocol was implemented in our Institute starting January 2011 ending January 1 2020. During this period, all patients with a suspicion of primary liver neoplasia either on CT or MRI will be evaluated in different departments from our Institute for possible inclusion. Patients with a typical aspect of benign FLLs will not be included in the study. Patients fulfilling the following criteria: presence of cirrhosis or other chronic liver disease (according to a liver stiffness evaluated by transient elastography higher than 10 kilopascals), Child-Pugh score no higher than B7 and absence of perihepatic ascites, platelet count \> 50.000 per mm3 or an international normalized ratio \< 1.6; will be further on sent to the department of interventional ultrasound. ). All patients referred to interventional department will underwent a B-mode ultrasound (1 investigator) testing the feasibility of performing liver biopsy. At this time point the conspicuity of the tumors will be recorded into either poorly or not poorly visible. Included patients will be randomly divided by another investigator (T.M.) without access to the previous US, CT or MRI report into two groups: a group that will underwent US guided liver biopsy (USLB) and another one who will underwent CEUS guided liver biopsy (CEUSLB). The randomization will be made based of flip coin technique. The side of the coin (heads-USLB, tails CEUSLB) determined the assignment of each subject. All biopsies will be performed by the same investigator (Z.S.) with an experience of more than 8 years in ultrasound interventions. Patients assigned to USLB or CEUSLB will be blinded. The investigators assessing the outcomes will not be informed about the LB technique used in each patient. The reasons for performing biopsy will be either inconclusive CT/MRI findings , or patients with a typical pattern of HCC on CT/MRI in whom a histological diagnosis is necessary in order to start systemic therapy (sorafenib). Different from other major society's guidelines, in our country a histological diagnosis of HCC is mandatory in patients referred for sorafenib treatment. Patients with small FLLs (BCLC 0 or A) and typical aspect of HCC on CT/MRI will be sent directly to surgery or radiofrequency ablation according to EASL guidelines.

A prospective parallel group clinical trial

Contrast Enhanced Ultrasound Guidance Biopsy for the Diagnosis of Liver Tumors

Real Time Contrast-enhanced Compared to Conventional Ultrasound Guided Biopsy in the Diagnosis of Hepatic Tumors on a Background of Advanced Chronic Liver Disease. A Prospective Clinical Study.

De-identified individual participant data for all primary and secondary outcome measures will be made available

In patients in whom a final histological diagnosis can not be achieved with the use of contrast enhanced or ultrasound guidance a second liver biopsy will be considered if appropriate in the next 3-4 weeks. In cases where a second liver biopsy will be judged not to be necessary a follow-up using imaging techniques will be performed until a final diagnosis is reached.

Iuliu Hatieganu University of Medicine and Pharmacy

MD Associate Specialist

therre is no intervention diagnosis or treatment for patients

Ultrasound (US) as first-line imaging technology in detecting focal liver lesions,also plays a crucial role in evaluating image and guiding ablation which is the main treatment for liver lesions. However, the effect of US in diagnosing liver lesions is challenged by several factors including being highly dependent on doctor's experience, low signal-to-noise ratio, low resolution for lesion feature,large error from thermal field evaluation during the process of ablation and so on. Therefore, it is of great significance to construct an intelligent US analysis system depending on the digital information technology. Basing on these problems,the following research will be involved in our project: 1) US database of liver lesions with seamless connection to Picture Archiving and Communication Systems (PACS) will be developed, with the aim to provide standard data for intelligent US analysis. 2) Deep learning model for accurate segmentation, detection and classification of liver lesions on US images will be studied. Then automatic extraction, selection and analysis of liver lesion ultrasound features and the intelligent US diagnosis for liver lesions will be realized. 3) Proposing a clustering model with deep image features, and depicting the similarity measurement of liver cancer, which can be furthered used to link the liver cancer feature to optimal ablation parameters. The intelligent decision-making system for quantifying thermal ablation will be established. 4) Regression algorithm and Generative Adversarial Nets will be developed to extract the image features of liver cancer which will predict risk factors after US-guided thermal ablation.Based on the above researches, it is of great value to establish an intelligent focal liver lesion US diagnosis system involving intelligent diagnosis,personalized ablation strategy and accurate prognosis evaluation, improving the level of accurate diagnosis and treatment of liver lesions.

Utility of Ultrasound Imaging for Diagnosis of Focal Liver Lesions: A Radiomics Analysis

Intelligent Diagnosis of Focal Liver Lesions and Thermal Ablation Zone of Liver Cancer Based on Ultrasound Imaging

diagnosis specificity of intelligent ultrasound analysis

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Radiomics Analysis of Focal Liver Lesions Based on Contrast-Enhanced Ultrasound Imaging	NCT04682886	Focal Liver Les... Contrast-enhanc...	diagnosis	-	Chinese PLA General Hospital
Prospective Multicenter Study on Clinical Application of Sonazoid in Liver Tumor	NCT04563897	Ultrasound		18 Years -	Chinese PLA General Hospital
Contrast Enhanced Ultrasound Guidance Biopsy for the Diagnosis of Liver Tumors	NCT03811431	Liver Diseases	Contrast enhanc...	18 Years -	Iuliu Hatieganu University of Medicine and Pharmacy
Prospective Multicenter Study on Clinical Application of Sonazoid in Liver Tumor	NCT04563897	Ultrasound		18 Years -	Chinese PLA General Hospital
Utility of Ultrasound Imaging for Diagnosis of Focal Liver Lesions: A Radiomics Analysis	NCT03871140	Focal Liver Les... Ultrasonics Intelligent Dia... Ablation Radiomics	diagnosis	-	Chinese PLA General Hospital
Utility of Ultrasound Imaging for Diagnosis of Focal Liver Lesions: A Radiomics Analysis	NCT03871140	Focal Liver Les... Ultrasonics Intelligent Dia... Ablation Radiomics	diagnosis	-	Chinese PLA General Hospital
Radiomics Analysis of Focal Liver Lesions Based on Contrast-Enhanced Ultrasound Imaging	NCT04682886	Focal Liver Les... Contrast-enhanc...	diagnosis	-	Chinese PLA General Hospital

Spots Global Cancer Trial Database for focal liver lesions