Katherine Elizabeth Maturen MD, Presenter: Nothing to Disclose

Ashish Wasnik MD, Abstract Co-Author: Nothing to Disclose

Janet E. Bailey MD, Abstract Co-Author: Nothing to Disclose

Ellen J. Higgins MS, Abstract Co-Author: Nothing to Disclose

Jonathan Matthew Rubin MD, PhD, Abstract Co-Author: Consultant, General Electric Company Consultant, ZONARE Medical Systems, Inc Equipment support, ZONARE Medical Systems, Inc Research grant, General Electric Company Equipment support, General Electric Company

To assess sonographic appearances of hepatocellular carcinoma (HCC) with particular attention to posterior acoustic effect.

We performed an IRB-approved retrospective review of patients with HCC who had undergone radiofrequency ablation in our department between 2001-2010. Ultrasound images prior to procedure were reviewed by a consensus group of three subspecialist abdominal radiologists. Imaging characteristics were tabulated and correlated with patient data.

161 masses were identified, of which 8 were excluded due to prior angioembolization (altering sonographic appearance) or lack of correlative patient information. 153 masses in 118 patients (83 men, 35 women, average age 59) constituted the study population. 80% of masses (n=123) arose in livers that were either somewhat or markedly echogenic/attenuating. 61% of masses (n=93) were hypoechoic; 21% (n=32) isoechoic; and 18% (n=28) hyperechoic with respect to adjacent parenchyma. The majority (56%, n=87) of masses had no specific posterior acoustic effect but 42% exhibited either minimal (n=41) or marked (n=23) posterior acoustic enhancement. The remaining masses (n=2) had posterior shadowing.

Posterior acoustic enhancement is present to some degree in almost half of HCC, which may relate to both intrinsic tumor characteristics and the high background sonographic attenuation of the cirrhotic liver. This feature of HCC is not widely recognized and may contribute to sonographic screening for HCC in patients with liver disease.

Nearly half of hepatocellular carcinomas (HCC) exhibit posterior acoustic enhancement and attention to this finding is recommended during ultrasound screening for HCC in liver disease patients.

Maturen, K, Wasnik, A, Bailey, J, Higgins, E, Rubin, J, Posterior Acoustic Enhancement: A Useful Imaging Sign in Hepatocellular Carcinoma.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9002140.html