Reviewer ’s report  
 
Title: Three cases of histologically proven hepatic epithelioid  hemangioendothelioma evaluated 
using a second -generation microbubble contrast medium in ultr asonography: case reports  
 
Version: 2 Date: 02 Nov 2019  
 
Reviewer: Guntars Pupelis  
 
Reviewer's report:  
 
Reviewer report 1  
 
BMC Gastroenterology manuscript "Three cases of histologically proven hepatic epithelioid 
hemangioendothelioma evaluated using a second -generation microbubble contrast medium in 
ultrasonography: case reports".  
 
The authors report tree cases when hepatic epi thelioid hemangioendothelioma has been verified 
based on clinical, laboratory and different visual diagnostic criteria. The latter included 
conventional abdominal US, CEET, MRI in comparison to contrast -enhanced ultrasonography 
(CEUS).  
 
Reported background information and case description are well prepared and informative. A 
comparison of finding on CEUS and other imaging is convincing. CEUS gives a more detailed 
comprehension of possible liver nodular pathology with observations of the findings in the late 
portal phases, especially if it is confirmed by histologic diagnoses. The better differential 
diagnoses with other hypervascular nodular liver lesions are important.  
 
The less convincing however is disease outcome description of the first case due to lost f ollow -
up and in the second case due to the advanced age of the patient. The case report merits to be 
published.  
 
 
Reviewer report 2  
 
The authors have complemented the manuscript with the needed details according to reviewer 
recommendations. Due to innovative  and valuable information, the manuscript merit publication 
even considering some shortcomings associated with the case presentation form.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or  would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary 
from an organisation that may in any way gain or lose financial ly from the 
publication of this manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or 
lose financi ally from the publication of this manuscript, either now or in the 
future?  
 
3. Do you hold or are you currently applying for any patents  relating to the content 
of the manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organiz ation 
that holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of th e above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under  an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editors, which will not be pu blished.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Three cases of histologically proven hepatic epithelioid  hemangioendothelioma evaluated 
using a second -generation microbubble contrast medium in ultr asonography: case reports  
 
Version: 2 Date: 02 Nov 2019  
 
Reviewer: Guntars Pupelis  
 
Reviewer's report:  
 
Reviewer report 1  
 
BMC Gastroenterology manuscript "Three cases of histologically proven hepatic epithelioid 
hemangioendothelioma evaluated using a second -generation microbubble contrast medium in 
ultrasonography: case reports".  
 
The authors report tree cases when hepatic epi thelioid hemangioendothelioma has been verified 
based on clinical, laboratory and different visual diagnostic criteria. The latter included 
conventional abdominal US, CEET, MRI in comparison to contrast -enhanced ultrasonography 
(CEUS).  
 
Reported background information and case description are well prepared and informative. A 
comparison of finding on CEUS and other imaging is convincing. CEUS gives a more detailed 
comprehension of possible liver nodular pathology with observations of the findings in the late 
portal phases, especially if it is confirmed by histologic diagnoses. The better differential 
diagnoses with other hypervascular nodular liver lesions are important.  
 
The less convincing however is disease outcome description of the first case due to lost f ollow -
up and in the second case due to the advanced age of the patient. The case report merits to be 
published.  
 
 
Reviewer report 2  
 
The authors have complemented the manuscript with the needed details according to reviewer 
recommendations. Due to innovative  and valuable information, the manuscript merit publication 
even considering some shortcomings associated with the case presentation form.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or  would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary 
from an organisation that may in any way gain or lose financial ly from the 
publication of this manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or 
lose financi ally from the publication of this manuscript, either now or in the 
future?  
 
3. Do you hold or are you currently applying for any patents  relating to the content 
of the manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organiz ation 
that holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of th e above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under  an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editors, which will not be pu blished.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: Three cases of histologically proven hepatic epithelioid  hemangioendothelioma evaluated 
using a second -generation microbubble contrast medium in ultr asonography: case reports  
 
Version: 2 Date: 02 Nov 2019  
 
Reviewer: Guntars Pupelis  
 
Reviewer's report:  
 
Reviewer report 1  
 
BMC Gastroenterology manuscript "Three cases of histologically proven hepatic epithelioid 
hemangioendothelioma evaluated using a second -generation microbubble contrast medium in 
ultrasonography: case reports".  
 
The authors report tree cases when hepatic epi thelioid hemangioendothelioma has been verified 
based on clinical, laboratory and different visual diagnostic criteria. The latter included 
conventional abdominal US, CEET, MRI in comparison to contrast -enhanced ultrasonography 
(CEUS).  
 
Reported background information and case description are well prepared and informative. A 
comparison of finding on CEUS and other imaging is convincing. CEUS gives a more detailed 
comprehension of possible liver nodular pathology with observations of the findings in the late 
portal phases, especially if it is confirmed by histologic diagnoses. The better differential 
diagnoses with other hypervascular nodular liver lesions are important.  
 
The less convincing however is disease outcome description of the first case due to lost f ollow -
up and in the second case due to the advanced age of the patient. The case report merits to be 
published.  
 
 
Reviewer report 2  
 
The authors have complemented the manuscript with the needed details according to reviewer 
recommendations. Due to innovative  and valuable information, the manuscript merit publication 
even considering some shortcomings associated with the case presentation form.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or  would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary 
from an organisation that may in any way gain or lose financial ly from the 
publication of this manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or 
lose financi ally from the publication of this manuscript, either now or in the 
future?  
 
3. Do you hold or are you currently applying for any patents  relating to the content 
of the manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organiz ation 
that holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of th e above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under  an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editors, which will not be pu blished.  
 
I agree to the open peer review policy of the journal  
assistant