{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:22:04Z","timestamp":1789690924033,"version":"4.0.1"},"reference-count":22,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T00:00:00Z","timestamp":1716508800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003653","name":"Korea National Institute of Health","doi-asserted-by":"publisher","award":["HI21C0974"],"award-info":[{"award-number":["HI21C0974"]}],"id":[{"id":"10.13039\/501100003653","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Purpose<\/jats:title>\n<jats:p>To evaluate the added value of contrast-enhanced ultrasonography (CEUS) using Sonazoid in characterizing focal liver lesions (FLLs) with indeterminate findings on gadoxetic acid-enhanced liver MRI in patients without risk factors for hepatocellular carcinoma (HCC).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Patients who underwent CEUS using Sonazoid for characterizing indeterminate FLLs on gadoxetic acid-enhanced liver MRI were. The indeterminate FLLs were classified according to the degree of malignancy on a 5-point scale on MRI and combined MRI and CEUS. The final diagnosis was made either pathologically or based on more than one-year follow-up. The diagnostic performance was assessed using a receiver operating characteristic (ROC) curve analysis, and the net reclassification improvement (NRI) was calculated.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 97 patients (mean age, 49 years \u00b1 16, 41 men, 80 benign and 17 malignant lesions) were included. When CEUS was added to MRI, the area under the ROC curve increased, but the difference was not statistically significant (0.87 [95% confidence interval {CI}, 0.77\u20130.98] for MRI vs 0.93 [95% CI, 0.87\u20130.99] for CEUS added to MRI, <jats:italic>P<\/jats:italic> = 0.296). The overall NRI was 0.473 (95% CI, 0.100\u20130.845; <jats:italic>P<\/jats:italic> = 0.013): 33.8% (27\/80) of benign lesions and 41.2% (7\/17) of malignant lesions were appropriately reclassified, whereas 10.0% (8\/80) of benign lesions and 17.6% (3\/17) of malignant lesions were incorrectly reclassified.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Although performing CEUS with Sonazoid did not significantly improve the overall diagnostic performance in characterizing indeterminate FLLs on gadoxetic acid-enhanced liver MRI in patients without risk factors for HCC, it may increase radiologist\u2019s confidence in classifying FLLs.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0304352","type":"journal-article","created":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T17:27:55Z","timestamp":1716571675000},"page":"e0304352","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Value of Sonazoid-enhanced ultrasonography in characterizing indeterminate focal liver lesions on gadoxetic acid-enhanced liver MRI in patients without risk factors for hepatocellular carcinoma"],"prefix":"10.1371","volume":"19","author":[{"given":"Ji Yoon","family":"Ban","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae Wook","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0676-2116","authenticated-orcid":true,"given":"Woo Kyoung","family":"Jeong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min Woo","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2683-8795","authenticated-orcid":true,"given":"Boram","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2767-3622","authenticated-orcid":true,"given":"Kyoung Doo","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,5,24]]},"reference":[{"issue":"1","key":"pone.0304352.ref001","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1097\/00004424-200001000-00009","article-title":"Human pharmacokinetics and safety evaluation of SonoVue, a new contrast agent for ultrasound imaging","volume":"35","author":"DR Morel","year":"2000","journal-title":"Invest Radiol"},{"issue":"5","key":"pone.0304352.ref002","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1016\/j.ultrasmedbio.2007.11.006","article-title":"Physicochemical characteristics of Sonazoid, a new contrast agent for ultrasound imaging","volume":"34","author":"PC Sontum","year":"2008","journal-title":"Ultrasound Med Biol"},{"issue":"1","key":"pone.0304352.ref003","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1159\/000367761","article-title":"Breakthrough Imaging in Hepatocellular Carcinoma","volume":"5","author":"M. 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