Clinical Value of Contrast Enhanced Ultrasonography in Evaluating Interventional Therapeutic Response of Hepatocellular Carcinoma

  • Prof Qin Si, Department of Ultrasound, The PLA 81st Hospital, Nanjing,China, China
  • Xushun Liu, Department of Ultrasound, The PLA 81st Hospital, Nanjing,China, China
  • Wei Tong, Department of Ultrasound, The PLA 81st Hospital, Nanjing,China, China
  • Jian Chen, Department of Ultrasound, The PLA 81st Hospital, Nanjing,China, China
  • Xiaoli Qian, Department of Ultrasound, The PLA 81st Hospital, Nanjing,China, China
  • Shengxi Huang, Department of Ultrasound, The PLA 81st Hospital, Nanjing,China, China
  • Xiaoping Lv, Department of Ultrasound, The PLA 81st Hospital, Nanjing,China, China

    • Background/Aims: To estimate the ability of contrast enhanced ultrasound (CEUS), compared with contrast enhanced computed tomography (CECT) and digital subtraction angiography (DSA), in evaluating treatment response of hepatocellular carcinoma after interventional procedure.
    Method: 103 patients with 136 lesions, in total, confirmed by pathology were enrolled in the study. After the interventional procedure, within 30±7 days, four imaging modalities, which are US, CEUS, CECT, DSA, were used to assess the response of the 136 lesions was. CECT combined with DSA (CECT/DSA) served as the reference standard. CEUS examination was performed by using sulphur hexafluoride-filled microbubble contrast agent and real-time contrast-specific imaging technique.
    Results: One month after the treatment, the deactivation of the tumor was observed in 86/136 (63.2%) lesions by CEUS and 87/136 (64%) lesions by CECT/DSA, while the residues of the tumor were seen in 50/136 (36.8%) through CEUS and 44/136 (32.4%) through CECT/DSA. Compared with CECT/DSA, the sensitivity, specificity and accuracy of CEUS were 95.8%,95.6% and 98.5% in detecting deactivation and residues, while those of US were 92.3%,77.4% and 83.1%. Evaluation results of CEUS were highly consistent with those of enhanced CT / DSA (Kappa=0.83), yet the Kappa value of the common ultrasound was significantly low (Kappa=0.55).
    Conclusion: Compare with those data obtained through CECT/DSA separately, CEUS showed its superiority over US. It is proved that CEUS is a reliable way in estimating the response of hepatocellular carcinoma after interventional therapeutic.