Annamaria Deganello, Presenter: Nothing to Disclose

Joseph Jacob MBBS,MRCP, Abstract Co-Author: Nothing to Disclose

Preena Patel, Abstract Co-Author: Nothing to Disclose

Maria Sellars FRCR, Abstract Co-Author: Nothing to Disclose

Dino Hadzic, Abstract Co-Author: Nothing to Disclose

Paul Singh Sidhu MD, Abstract Co-Author: Speaker, Bracco Group Speaker, Siemens AG, Erlanger Speaker, Hitachi, Ltd

To determine the accuracy of CEUS in characterising pediatric focal liver lesions (FLL) in comparison to computerised tomography (CT), magnetic resonance (MR) and positron emission tomography (PET) imaging or histology as the reference standard.

Children referred for assessment of FLL over a 3 year period underwent a CEUS examination following fully informed parental consent. CEUS was performed by experienced examiners using a Siemens (Mountain View CA) S2000, a 4C1 transducer, and 1.2-2.4 mls of SonoVue (Bracco SpA Milan). A standard multiphase CEUS was performed and recorded with all children undergoing further imaging or follow-up with ultrasound. A comparison of the CEUS results, arrived by consensus, was compared to the reference standard to ascertain the accuracy of CEUS in characterising FLL.

A total of 21 children, (Female=11, Male=10, mean age 13.3, range 15 mths-17yrs) were examined with no contrast reactions recorded. 16 children were referred for assessment of a FLL in chronic liver disease, 2 for suspected metastases (treated primary malignancy) and 3 with FLL and no relevant clinical history. Following CEUS, the following were identified: regenerative nodules (n=7), focal fatty sparing (n=5), hepatic adenoma 9n=2), hemangioma (n=4), metastases (n=1), focal fatty infiltration (n=1) and focal nodular hyperplasia (FNH) (n=1). On comparison with CT, MR, PET imaging or biopsy, 16/21 (76%) demonstrated full concordance with CEUS. in 2 discordant cases, neither CT nor MR imaging could characterize the nature of the FLL and in the other 3 cases other modalities diagnosed a different benign lesion to CEUS.

These findings demonstrate the usefulness of CEUS in characterising FLL compared to traditional methods. CEUS represents a viable, safe, radiation free, cost-effective method for the assessment of FLL in this group and most importantly has the potential of reducing the radiation burden in a young population.

CEUS is a viable imaging alternative to CT or MRI in delineating paediatric FLL and reduces radiation burden in a cohort at risk for cancer who receive numerous repeated investigations.

Deganello, A, Jacob, J, Patel, P, Sellars, M, Hadzic, D, Sidhu, P, Delineation and Characterization of Pediatric Focal Liver Lesions Using Contrast-enhanced Ultrasound (CEUS): Preliminary Results.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11034219.html