Table 4.
Differences between SonoVue and Sonazoid for HCC diagnosis
| SonoVue | Sonazoid | |
|---|---|---|
| Composition | Gas: Sulfur hexafluoride | Gas: Perfluorobutane |
| Shell: mixture of DSPC and DPPG.Na | Shell: H-EPSNa | |
| Pharmacokinetics | Blood pool agent | Initial vascular distribution, then taken up by Kupffer cells |
| Image acquisition | Vascular phase only | Vascular and Kupffer phase ± re-injection technique |
| Advantages | Widely available | Allowing both vascular and Kupffer phase imaging |
| Widely studied with well-established diagnostic criteria | Re-injection technique may help increase diagnostic performance | |
| Stable time window of Kupffer phase: whole liver evaluation available | ||
| Disadvantages | No Kupffer phase imaging | Not yet available in some regions |
| Short time window of vascular phase: only limited number of lesions can be examined | Less studied than SonoVue | |
| Kupffer phase-related limitations: 1) false negative for hyperechoic lesions or well-differentiated HCCs, 2) theoretical pseudo-washout effect |
HCC, hepatocellular carcinoma; DSPC, distearoylphosphatidylcholine; DPPG.Na, dipalmitoyl phosphatidylglycerol sodium; H-EPSNa, hydrogenated egg phosphatidylserine sodium.