Enhancement Patterns of Hepatocellular Carcinoma at Contrast-enhanced US: Comparison with Histologic Differentiation
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Bibliographic record
Abstract
PURPOSE: To retrospectively compare the arterial and portal venous phase enhancement patterns of hepatocellular carcinoma (HCC) at contrast material-enhanced ultrasonography (US) with the degree of HCC histologic differentiation. MATERIALS AND METHODS: This study was approved by the research ethics board, and informed consent was obtained. The study population included 112 consecutive patients (91 men, 21 women; aged 25-86 years) with 112 histologically proved HCCs: 23 well differentiated, 77 moderately differentiated, and 12 poorly differentiated. All underwent continuous real-time low-mechanical-index contrast-enhanced US from wash-in of contrast material to 300 seconds by using a blood-pool microbubble agent. Initial image interpretation included arterial enhancement, dysmorphic intratumor arteries, and presence and time of negative enhancement (washout). Enhancement patterns were compared with histologic differentiation by using the Fisher exact test. RESULTS: In the arterial phase, 97 of 112 (87%) HCCs showed hypervascularity, with a significantly higher proportion in moderately differentiated HCCs (74 of 77, 96%) when compared with well- (14 of 23, 61%; P<.001) and poorly differentiated HCC (nine of 12, 75%; P<.004). Eight of 112 (7%) were isovascular and seven (6%) were hypovascular. Dysmorphic arteries were seen in 81 (72%) HCCs. Of 97 hypervascular tumors, only 42 (43%) showed typical washout by 90 seconds. Late washout appeared in 25 (26%) HCCs in the 91-180 seconds phase and in 21 (22%) in the 181-300 seconds phase. The remaining nine showed no washout up to 300 seconds and seven (78%) were well-differentiated HCCs. CONCLUSION: Moderately differentiated HCC generally shows classic enhancement features, while well- and poorly differentiated tumors account for most atypical variations. Extended observation in the portal phase is important as late washout occurs with slightly more frequency than washout in the conventionally defined portal venous phase.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it