Characterization of non-alcoholic fatty liver disease–related hepatocellular carcinoma on contrast-enhanced ultrasound with Sonazoid

Purpose This study aimed to evaluate the contrast-enhanced ultrasound with Sonazoid (Sonazoid-CEUS) features of hepatocellular carcinoma (HCC) in patients with non-alcoholic fatty liver disease (NAFLD). Methods In this retrospective study, patients who underwent surgical resection and were histopath...

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Main Authors: Yi Dong, Juan Cheng, Yun-Lin Huang, Yi-Jie Qiu, Jia-Ying Cao, Xiu-Yun Lu, Wen-Ping Wang, Kathleen Möller, Christoph F. Dietrich
Format: Article
Language:English
Published: Korean Society of Ultrasound in Medicine 2025-05-01
Series:Ultrasonography
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Online Access:http://www.e-ultrasonography.org/upload/usg-24205.pdf
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author Yi Dong
Juan Cheng
Yun-Lin Huang
Yi-Jie Qiu
Jia-Ying Cao
Xiu-Yun Lu
Wen-Ping Wang
Kathleen Möller
Christoph F. Dietrich
author_facet Yi Dong
Juan Cheng
Yun-Lin Huang
Yi-Jie Qiu
Jia-Ying Cao
Xiu-Yun Lu
Wen-Ping Wang
Kathleen Möller
Christoph F. Dietrich
author_sort Yi Dong
collection DOAJ
description Purpose This study aimed to evaluate the contrast-enhanced ultrasound with Sonazoid (Sonazoid-CEUS) features of hepatocellular carcinoma (HCC) in patients with non-alcoholic fatty liver disease (NAFLD). Methods In this retrospective study, patients who underwent surgical resection and were histopathologically diagnosed with NAFLD or cirrhosis-related HCC were included. All patients received Sonazoid-CEUS examinations within 1 week prior to hepatic surgery. The enhancement patterns of HCC lesions were evaluated and compared between the two groups according to the current World Federation for Ultrasound in Medicine and Biology guidelines. Multivariate logistic regression analysis was used to assess the correlations between Sonazoid-CEUS enhancement patterns and clinicopathologic characteristics. Results From March 2022 to April 2023, a total of 151 patients with HCC were included, comprising 72 with NAFLD-related HCC and 79 with hepatitis B virus (HBV) cirrhosis–related HCC. On Sonazoid-CEUS, more than half of the NAFLD-related HCCs exhibited relatively early and mild washout within 60 seconds (54.2%, 39/72), whereas most HBV cirrhosis–related HCCs displayed washout between 60 and 120 seconds (46.8%, 37/79) or after 120 seconds (39.2%, 31/79) (P<0.001). In the patients with NAFLD-related HCC, multivariate analysis revealed that international normalized ratio (odds ratio [OR], 0.002; 95% confidence interval [CI], 0.000 to 0.899; P=0.046) and poor tumor differentiation (OR, 21.930; 95% CI, 1.960 to 245.319; P=0.012) were significantly associated with washout occurring within 60 seconds. Conclusion Characteristic Sonazoid-CEUS features are useful for diagnosing HCC in patients with NAFLD.
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spelling doaj-art-008cfb399dd046608cc4f5d8b344d7932025-08-20T03:48:57ZengKorean Society of Ultrasound in MedicineUltrasonography2288-59432025-05-0144323224210.14366/usg.242051758Characterization of non-alcoholic fatty liver disease–related hepatocellular carcinoma on contrast-enhanced ultrasound with SonazoidYi Dong0Juan Cheng1Yun-Lin Huang2Yi-Jie Qiu3Jia-Ying Cao4Xiu-Yun Lu5Wen-Ping Wang6Kathleen Möller7Christoph F. Dietrich8 Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China Medical Department I/Gastroenterology, SANA Hospital Lichtenberg, Berlin, Germany Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaPurpose This study aimed to evaluate the contrast-enhanced ultrasound with Sonazoid (Sonazoid-CEUS) features of hepatocellular carcinoma (HCC) in patients with non-alcoholic fatty liver disease (NAFLD). Methods In this retrospective study, patients who underwent surgical resection and were histopathologically diagnosed with NAFLD or cirrhosis-related HCC were included. All patients received Sonazoid-CEUS examinations within 1 week prior to hepatic surgery. The enhancement patterns of HCC lesions were evaluated and compared between the two groups according to the current World Federation for Ultrasound in Medicine and Biology guidelines. Multivariate logistic regression analysis was used to assess the correlations between Sonazoid-CEUS enhancement patterns and clinicopathologic characteristics. Results From March 2022 to April 2023, a total of 151 patients with HCC were included, comprising 72 with NAFLD-related HCC and 79 with hepatitis B virus (HBV) cirrhosis–related HCC. On Sonazoid-CEUS, more than half of the NAFLD-related HCCs exhibited relatively early and mild washout within 60 seconds (54.2%, 39/72), whereas most HBV cirrhosis–related HCCs displayed washout between 60 and 120 seconds (46.8%, 37/79) or after 120 seconds (39.2%, 31/79) (P<0.001). In the patients with NAFLD-related HCC, multivariate analysis revealed that international normalized ratio (odds ratio [OR], 0.002; 95% confidence interval [CI], 0.000 to 0.899; P=0.046) and poor tumor differentiation (OR, 21.930; 95% CI, 1.960 to 245.319; P=0.012) were significantly associated with washout occurring within 60 seconds. Conclusion Characteristic Sonazoid-CEUS features are useful for diagnosing HCC in patients with NAFLD.http://www.e-ultrasonography.org/upload/usg-24205.pdfnon-alcoholic fatty liver diseasehepatocellular carcinomacontrast-enhanced ultrasoundsonazoidkupffer phase
spellingShingle Yi Dong
Juan Cheng
Yun-Lin Huang
Yi-Jie Qiu
Jia-Ying Cao
Xiu-Yun Lu
Wen-Ping Wang
Kathleen Möller
Christoph F. Dietrich
Characterization of non-alcoholic fatty liver disease–related hepatocellular carcinoma on contrast-enhanced ultrasound with Sonazoid
Ultrasonography
non-alcoholic fatty liver disease
hepatocellular carcinoma
contrast-enhanced ultrasound
sonazoid
kupffer phase
title Characterization of non-alcoholic fatty liver disease–related hepatocellular carcinoma on contrast-enhanced ultrasound with Sonazoid
title_full Characterization of non-alcoholic fatty liver disease–related hepatocellular carcinoma on contrast-enhanced ultrasound with Sonazoid
title_fullStr Characterization of non-alcoholic fatty liver disease–related hepatocellular carcinoma on contrast-enhanced ultrasound with Sonazoid
title_full_unstemmed Characterization of non-alcoholic fatty liver disease–related hepatocellular carcinoma on contrast-enhanced ultrasound with Sonazoid
title_short Characterization of non-alcoholic fatty liver disease–related hepatocellular carcinoma on contrast-enhanced ultrasound with Sonazoid
title_sort characterization of non alcoholic fatty liver disease related hepatocellular carcinoma on contrast enhanced ultrasound with sonazoid
topic non-alcoholic fatty liver disease
hepatocellular carcinoma
contrast-enhanced ultrasound
sonazoid
kupffer phase
url http://www.e-ultrasonography.org/upload/usg-24205.pdf
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