Page 10 - 台灣肝癌醫學冬季會手冊-1222-V3_Neat

Hepatocellular carcinoma diagnosis by contrast-enhanced ultrasound or EOB MRI

Shen-Yung Wang

Mackay Memorial Hospital

以對比增強超音波或肝特異顯影劑磁振造影診斷肝細胞癌

王勝永

馬偕紀念醫院

Ultrasound contrast agents (UCA) are gas-filling microbubbles capable of enhancing the sonographic signals of

blood flow to provide dynamic features of focal liver lesions. Thus, contrast-enhanced ultrasound (CEUS) is

superior to conventional grayscale ultrasound for the diagnosis of focal liver lesion including hepatocellular

carcinoma (HCC). Sonazoid, a newer generation of UCA, has been available in Taiwan. It can provide Kupffer

phase CEUS which can facilitate the diagnosis of HCC. CEUS can detect arterial hypervascularity and better

demonstration of rapid washout for non-HCC malignancy and the very late washout of HCC. Gadoxetic acid

(Gd-EOB-DTPA) is a newer-generation, selective hepatocyte-uptake MRI contrast agent that can provide

hepatocyte-phase imaging. Gd-EOB-DTPA-enhanced MRI (EOB MRI) has a role in the differential diagnosis

of earliest transformation of HCC, including high-grade dysplastic nodules and early HCC. Adding EOB MRI

can improve the evaluation of tumor burden and tumor staging to optimize HCC treatment. Recently, the

Taiwan Liver Cancer Association and the Gastroenterological Society of Taiwan published the 2020 update on

management consensus guideline for HCC, and the guideline included updated information of CEUS and EOB
MRI into the consensus. This session will discuss the application of CEUS and EOB MRI for HCC diagnosis.