ArticleAbdominal radiology (New York)2025
Role of Superb Microvascular Imaging (SMI) vascularity index values and vascularity patterns in the differential diagnosis of malignant liver lesions.
Article in Abdominal radiology (New York), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- [Ultrasound technology's new application in the diagnosis and treatment of liver cancer].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026Review
- Assessment of the prevalence and consistency of microvascular flow imaging patterns in focal nodular hyperplasia.Pathology oncology research : POR · 2026Article
- Comparative Evaluation of Superb Microvascular Imaging and Dynamic Contrast-Enhanced Magnetic Resonance Imaging in Differentiating Benign and Malignant Breast Masses.Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine · 2025Article
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6 authors.
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Abstract
purposeTo evaluate the Superb Microvascular Imaging (SMI) vascular patterns and vascularity index (VI) values of malignant focal liver lesions (FLLs), assess their role in differential diagnosis, and examine interobserver agreement. MATERIALS AND
methodsA total of 107 patients (52 males, 55 females; mean age 62 ± 12.8 years, range 25-87) referred to the interventional radiology clinic for FLL biopsy between April 2022 and April 2023 were analyzed. Two radiologists independently assessed the SMI vascular patterns and calculated VI values. Differences among three lesion groups - hepatocellular carcinoma (HCC, n = 16), non-HCC primary liver malignancies (n = 16), and metastases (n = 75) - were evaluated, and interobserver agreement was assessed.
resultsMost metastases (88%) demonstrated hypovascular patterns, while HCCs predominantly exhibited hypervascular patterns (68.7-81.3%). Non-HCC primary malignancies showed no dominant vascular pattern. Significant differences in SMI patterns were observed among lesion types (p = 0.001-0.035). VI values for HCCs (7.53-7.73) were significantly higher than those for non-HCC malignancies (2.73-2.93) and metastases (1.35-1.36) (p = 0.0001). ROC analysis based on VI values yielded AUCs of 0.886-0.887, with a cutoff of 2.92 providing 81.3% sensitivity and 79.1-80.2% specificity for HCC diagnosis. The inter-reader agreement for SMI patterns had a kappa score of 0.634, while the intraclass correlation coefficient (ICC) for VI values was 0.959.
conclusionHCCs displayed more hypervascular SMI patterns and significantly higher VI values compared to other malignant FLLs, emphasizing the diagnostic potential of VI in distinguishing HCC from non-HCC tumors. Although metastases primarily exhibited hypovascular patterns and low VI values, no dominant vascular pattern was identified in non-HCC primary liver malignancies. Assessing VI values provided higher interobserver agreement compared to SMI patterns, enhancing objectivity and reproducibility.
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