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We investigated the feasibility of using super-resolution ultrasound (SR-US) imaging for visualizing and quantifying the microvasculature of intraparenchymal FLLs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with FLLs between June 2022 and February 2023 were prospectively screened. Following bolus injection of microbubbles at clinical concentration, SR-US was performed using a high frame rate (350\u2013500\u2009Hz) modified ultrasound scanner and a convex array transducer with a central frequency of 3.1\u2009MHz.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 47 pathologically proven FLLs at a depth of 5.7\u2009\u00b1\u20091.7\u2009cm (mean\u2009\u00b1\u2009standard deviation) were included: 30 hepatocellular carcinomas (HCC), 11 liver metastases (LM), and 6 focal nodular hyperplasias (FNH). The smallest detectable vessel size of the hepatic microvasculature was 128.4\u2009\u00b1\u200918.6 \u03bcm (mean\u2009\u00b1\u2009standard deviation) at a depth of 8\u2009cm. Significant differences were observed among the three types of lesions in terms of pattern categories, vessel density, minimum flow velocity, and perfusion index. We observed higher vessel density for FNH\n                      <jats:italic>versus<\/jats:italic>\n                      liver parenchyma (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) as well as fractal dimension and local flow direction entropy value for FNH\n                      <jats:italic>versus<\/jats:italic>\n                      HCC (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002 and\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001, respectively) and for FNH\n                      <jats:italic>versus<\/jats:italic>\n                      LM (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006 and\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Multiparametric SR-US showed that these three pathological types of FLLs have specific microvascular phenotypes. Vessel density, fractal dimension and local flow direction entropy served as valuable parameters in distinguishing between benign and malignant FLLs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov (NCT06018142).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance statement<\/jats:title>\n                    <jats:p>Multiparametric SR-US imaging offers precise morphological and functional assessment of the microvasculature of intraparenchymal focal liver lesions, providing insights into tumor heterogeneity and angiogenesis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Super-resolution (SR)-US imaging allowed morphological and functional evaluation of intraparenchymal hepatic lesion microvasculature.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Hepatocellular carcinoma, liver metastasis, and focal nodular hyperplasia exhibit distinct microvascular architectures and hemodynamic profiles.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>\n                            Multiparametric microvasculature characterization\n                            <jats:italic>via<\/jats:italic>\n                            SR-US imaging facilitates the differentiation between benign and malignant microvascular phenotypes.\n                          <\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1186\/s41747-024-00540-3","type":"journal-article","created":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T06:21:39Z","timestamp":1733379699000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Focal liver lesions: multiparametric microvasculature characterization via super-resolution ultrasound imaging"],"prefix":"10.1186","volume":"8","author":[{"given":"Qian-Qian","family":"Zeng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi-Zhe","family":"An","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao-Nan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia-Cheng","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Xi","family":"Wan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Jin","family":"Zong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Hua","family":"Jian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7640-2351","authenticated-orcid":false,"given":"Ping","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,12,5]]},"reference":[{"key":"540_CR1","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1038\/nrc1093","volume":"3","author":"G Bergers","year":"2003","unstructured":"Bergers G, Benjamin LE (2003) Tumorigenesis and the angiogenic switch. 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