Abstract: Objective The aim of this study was to explore the differentiation of hepatocellular carcinoma (HCC) from metastatic liver cancer (MLC) by time-intensity curve (TIC) related parameters of contrast-enhanced ultrasonography(CEUS). Methods 106 patients with liver cancer were enrolled in our hospital between March 2021 and March 2023, and they all underwent CEUS examination, recording the TIC-related parameters, such as contrast agent arrival time (AT), time to peak (TTP), peak intensity (PI) and rising slope (RS) . The liver biopsies was performed. The receiver operating characteristic (ROC) curve was plotted and the area under the curve (AUC) was applied to evaluate the differential diagnostic efficacy of TIC parameters. Results Among the 106 patients with liver cancer, the pathological examination found HCC in 44 cases (41.5%) and MLC in 62 cases (58.5%); the AT and PI in HCC lesions were (9.1±2.2)s and (41.7±5.1)dB, both significantly lower than [(13.4±2.6)s and (45.8±5.5)dB, P<0.05], while the TTP was (24.8±4.7)s, significantly slower than [(18.9±3.4)s, P<0.05] in MLC foci; serum AFP levels in patients with HCC was (226.7±37.5)ng/mL, much higher than [(73.1±14.6)ng/mL, P<0.05] in patients with MLC; the ROC analysis showed that the AUC was 0.89(95%CI:0.83-0.96), with the sensitivity (Se) and specificity (Sp) of 70.5% and 95.2%, when the combination of AT, TTP and PI was applied to diagnose the HCC, much superior to serum AFP level, the latter had the AUC of 0.78(95%CI:0.68-0.79), with the Se and Sp of 56.8% and 78.8% (P<0.05), respectively. Conclusion The TIC-related parameters of CEUS have certain clinical application in the differential diagnosis of HCC from MLC, which needs multi-center verification.

Key words: Hepatoma, Metastatic liver cancer, Contrast-enhanced ultrasonography, Time-intensity curve, Time to peak, Diagnosis