Contrast-enhanced ultrasound for screening hepatocellular carcinoma: an implemented program at a semi-rural academic center.
PURPOSE
To describe our early experience using a contrast-enhanced ultrasound (CEUS) protocol for surveillance of hepatocellular carcinoma (HCC) at a semi-rural academic medical center.


METHODS
Retrospective, longitudinal study of the first 100 patients who underwent CEUS liver screening imaging over 2 years. Each patient underwent a standard of care abdominal ultrasound, which was checked with the radiologist, who searched for a focal lesion on the cine clips to target specifically with contrast. If none was present, the HCC contrast-enhanced screening protocol consisting of individual sweeps of the right and left lobes was performed from 0 to 60 s and 3-4 min post contrast-Lumason was utilized. Images, report details, and patient demographics were analyzed.


RESULTS
66 men and 34 women (average age, 59 ± 13 years) were included. On average, the distance from patient's home to our institution was 39 miles (range 2-179 miles). The majority of our patients were covered under Private insurance (46%) with 43% covered by Medicare. CEUS exams on average took 35 min to complete. Lumason was administered in split doses for an average total of 5 mL per exam. Of the 10 lesions identified, there were five LI-RADS 3, two LI-RADS 4, one LI-RADS 5, two LI-RADS M, and one bland portal vein thrombus. There were no complications reported.


CONCLUSION
This semi-rural single-center study demonstrates the feasibility of starting a HCC CEUS screening program. CEUS can be performed in conjunction with routine ultrasound imaging with added benefit of identifying and characterizing lesions in one setting.
['Motz|Victoria L|VL|0000-0001-8290-4369', 'White|Rachel|R|', 'Lee|Roland|R|', 'Vu|Tuan|T|', 'Shin|Benjamin|B|', 'McGillen|Kathryn L|KL|']
D000368:Aged D006528:Carcinoma, Hepatocellular D003287:Contrast Media D005260:Female D006801:Humans D008113:Liver Neoplasms D008137:Longitudinal Studies D008279:Magnetic Resonance Imaging D008297:Male D006278:Medicare D008875:Middle Aged D012189:Retrospective Studies D014463:Ultrasonography D014481:United States
Ultrasound HCC Li-RADS