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World J Radiol. Jun 28, 2010; 2(6): 215-223
Published online Jun 28, 2010. doi: 10.4329/wjr.v2.i6.215
Computer-aided diagnosis for contrast-enhanced ultrasound in the liver
Katsutoshi Sugimoto, Junji Shiraishi, Fuminori Moriyasu, Kunio Doi
Katsutoshi Sugimoto, Junji Shiraishi, Kunio Doi, Kurt Rossmann Laboratories for Radiologic Imaging Research, Department of Radiology, The University of Chicago, Chicago, IL 60637, United States
Katsutoshi Sugimoto, Fuminori Moriyasu, Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo 160-0023, Japan
Junji Shiraishi, School of Health Sciences, Kumamoto University, Kumamoto 862-0976, Japan
Author contributions: All authors analyzed and interpreted the data; Sugimoto K drafted the manuscript; Sugimoto K and Doi K researched the literature; Shiraishi J and Doi K edited the manuscript.
Correspondence to: Katsutoshi Sugimoto, MD, Department of Gastroenterology and Hepatology, Tokyo Medical University, Japan 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan. sugimoto@tokyo-med.ac.jp
Telephone: +81-3-33426111  Fax: +81-3-53816654
Received: February 21, 2010
Revised: May 6, 2010
Accepted: May 13, 2010
Published online: June 28, 2010
Abstract

Computer-aided diagnosis (CAD) has become one of the major research subjects in medical imaging and diagnostic radiology. The basic concept of CAD is to provide computer output as a second opinion to assist radiologists’ image interpretations by improving the accuracy and consistency of radiologic diagnosis and also by reducing the image-reading time. To date, research on CAD in ultrasound (US)-based diagnosis has been carried out mostly for breast lesions and has been limited in the fields of gastroenterology and hepatology, with most studies being conducted using B-mode US images. Two CAD schemes with contrast-enhanced US (CEUS) that are used in classifying focal liver lesions (FLLs) as liver metastasis, hemangioma, or three histologically differentiated types of hepatocellular carcinoma (HCC) are introduced in this article: one is based on physicians’ subjective pattern classifications (subjective analysis) and the other is a computerized scheme for classification of FLLs (quantitative analysis). Classification accuracies for FLLs for each CAD scheme were 84.8% and 88.5% for metastasis, 93.3% and 93.8% for hemangioma, and 98.6% and 86.9% for all HCCs, respectively. In addition, the classification accuracies for histologic differentiation of HCCs were 65.2% and 79.2% for well-differentiated HCCs, 41.7% and 50.0% for moderately differentiated HCCs, and 80.0% and 77.8% for poorly differentiated HCCs, respectively. There are a number of issues concerning the clinical application of CAD for CEUS, however, it is likely that CAD for CEUS of the liver will make great progress in the future.

Keywords: Computer-aided diagnosis, Focal liver lesion, Ultrasonography, Contrast agent, Micro-flow imaging