Harmonic imaging for the detection and differential diagnosis of focal liver lesions - preliminary results

Contrast harmonic imaging (CHI) is a new Doppler technology using the non-linear properties of ultrasound contrast agents. Aim: In this pilot study contrast harmonic imaging was evaluated for the detection and characterization of liver lesions, Methods: Tumor vascularity patterns and diagnostic accuracy in the differential diagnosis of liver lesions were compared in 50 liver lesions using gray-scale sonography, unenhanced and enhanced power Doppler sonography and CHI, In addition, CHI was compared to spiral-CT for the detection of liver metastases in 28 patients. Results: CHI was superior to power Doppler sonography in the visualization of vascularity pattern. Due to the better resolution and image quality of tumor vascularity the diagnostic accuracy of CHI in the differential diagnosis of liver lesions was higher (88% CHI versus 40% unenhanced power Doppler, and 58% contrast-enhanced power Doppler), In the detection of liver metastasis CHI showed a higher sensitivity (96,8%) compared to spiral-CT (74,6%) in 28 patients with 63 metastases. Conclusions: CHI is a promising new ultrasound technology to further improve the differential diagnosis of liver lesions and the detection of metastases.