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Various factors contribute to this variability, including the tumor blood flow, tumor size, internal echoes, and its location in livers with diffuse fibro\u2010cirrhotic changes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>Towards improving lesion detection, this study evaluates a vasodilator, hydralazine, to enhance the visibility of HCC by reducing its blood flow relative to the surrounding liver tissue.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>HCC were analyzed for tumor visibility measured for B\u2010mode, CUS, and hydralazine\u2010augmented\u2010contrast ultrasound (HyCUS) in an autochthonous HCC rat model. 21 tumors from 12 rats were studied. B\u2010mode and CUS images were acquired before hydralazine injection. Rats received an intravenous hydralazine injection of 5\u00a0mg\/kg, then images were acquired 20\u00a0min later. Four rats were used as controls. The difference in echo intensity of the lesion and the surrounding tissue was used to determine the visibility index (VI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The visibility index for HCC was found to be significantly improved with the use of HyCUS imaging compared to traditional B\u2010mode and CUS imaging. The visibility index for HCC was 16.5\u00a0\u00b1\u00a02.8 for HyCUS, compared to 5.3\u00a0\u00b1\u00a04.8 for B\u2010mode and 4.1\u00a0\u00b1\u00a03.8 for CUS. The differences between HyCUS and the other imaging modalities were statistically significant, with <jats:italic>p<\/jats:italic>\u2010values of 0.001 and 0.02, respectively. Additionally, when compared to control cases, HyCUS showed higher discrimination of HCC (VI\u00a0=\u00a06.4\u00a0\u00b1\u00a01.2) with a <jats:italic>p<\/jats:italic>\u2010value of 0.003, while B\u2010mode (VI\u00a0=\u00a06.7\u00a0\u00b1\u00a01.4, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.5) and CUS (VI\u00a0=\u00a06.4\u00a0\u00b1\u00a01.2, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.3) showed lower discrimination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Vascular blood flow modulation by hydralazine enhances the visibility of HCC. HyCUS offers a potential problem\u2010solving method for detecting HCC when B\u2010mode and CUS are unsuccessful, especially with background fibro\u2010cirrhotic liver disease. Future evaluation of the approach in humans will determine its translatability for clinical applications.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.16232","type":"journal-article","created":{"date-parts":[[2023,1,21]],"date-time":"2023-01-21T13:38:35Z","timestamp":1674308315000},"page":"1728-1735","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Hydralazine\u2010augmented contrast ultrasound imaging improves the detection of hepatocellular carcinoma"],"prefix":"10.1002","volume":"50","author":[{"given":"Laith R.","family":"Sultan","sequence":"first","affiliation":[{"name":"Ultrasound Research Lab, Department of Radiology University of Pennsylvania  Philadelphia Pennsylvania USA"},{"name":"Department of Radiology Children's hospital of Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mrigendra B.","family":"Karmacharya","sequence":"additional","affiliation":[{"name":"Department of Radiology Children's hospital of Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Al\u2010Hasani","sequence":"additional","affiliation":[{"name":"Ultrasound Research Lab, Department of Radiology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore W.","family":"Cary","sequence":"additional","affiliation":[{"name":"Department of Radiology Children's hospital of Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chandra M.","family":"Sehgal","sequence":"additional","affiliation":[{"name":"Ultrasound Research Lab, Department of Radiology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,1,30]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"International Agency for Research on Cancer.Cancer Tomorrow. 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