Characterization and detection of hepatocellular carcinoma (HCC): comparison of the ultrasound contrast agents SonoVue (BR 1) and Levovist (SH U 508A)--comparison of SonoVue and Levovist in HCC.

Objective: SonoVue and Levovist (SH U 508A) are both ultrasound contrast agents, which are helpful in characterization and detection of malignant liver lesions. This study was performed to compare both contrast agents according to the capability to diagnose hepatocellular carcinoma (HCC).

Methods: In a prospective study, 65 patients with histologically proven hepatocellular carcinoma (HCC) were examined with both, Levovist and SonoVue. In all patients HCC lesions had been detected by B-mode sonography before the study start. After injection of 2.4 ml SonoVue i. v., the liver was examined continuously for up to three minutes using "low MI"-pulse inversion sonography. For the Levovist-examinations 2.5 g Levovist were injected i. v. After a delay of at least 2.5 minutes without scanning, the liver was examined with three different scans using "high-MI"-pulse-inversion sonography.

Results: The examination was technically sufficient in 98% after SonoVue-injection and in 92% after Levovist-injection (n. s.). Comparison of the results was performed for the 60/65 patients (61 lesions), in which both methods were technically sufficient. After SonoVue-injection contrast-enhancement in the arterial phase was found in 79% (48/61) of the lesions. Demarcation of the HCC-lesion in the late phase was found in 89% of the SonoVue-examinations and in 98% of the Levovist-examinations (p < 0.05). Early SonoVue-enhancement and/or demarcation in SonoVue late-phase was found in 93% of the HCC-lesions (n. s. compared to Levovist-late phase).

Conclusions: Levovist-late phase has a higher sensitivity in predicting lesion dignity of HCC-lesions compared to SonoVue-late phase, but not compared to combination of SonoVue-early phase and late phase.