Contrast-enhanced ultrasound features of hepatocellular carcinoma in dogs

BACKGROUND: This study aimed to describe the contrast-enhanced ultrasound (CEUS) features of canine hepatocellular carcinoma (HCC) in relation to cellular differentiation and lesion size. METHODS: Sixty dogs with a cytological diagnosis of HCC and that underwent a CEUS examination were retrospectively selected. The wash-in and wash-out patterns of contrast enhancement, along with the time to wash-in and the time to wash-out, of each lesion were recorded. A dimensional cut-off value of 3 cm was adopted for classification. RESULTS: Cellular differentiation had a significant influence on both wash-in (chi-squared=16.99; P<0.001) and wash-out (chi-squared=10.9; P=0.004) patterns of contrast enhancement. Lesion size had a lower, but still significant, influence on both wash-in (chi-squared=12.7; P=0.005) and wash-out (chi-squared=7.42; P=0.024) patterns. A homogeneous hyperenhancement in the arterial phase followed by homogeneous wash-out were suggestive of a well-differentiated HCC. The cellular differentiation of lesions with inhomogeneous hyperenhancement or hypoenhancement/no enhancement as well as an inhomogeneous wash-out or no wash-out could not be inferred. CONCLUSIONS: No significant difference in the time to wash-in and the time to wash-out in relation to cellular differentiation or lesion size was evident. CEUS has the potential to improve efficiency in the diagnosis of HCCs in dogs.