A comparative study of dynamic 3-dimensional contrast-enhanced ultrasound and contrast-enhanced computed tomography for microwave ablation efficacy assessment of hepatocellular carcinoma

Abstract

Objective To explore the clinical significance of dynamic 3-dimensional contrast-enhanced ultrasound (D-3D-CEUS) in assessing the efficacy of microwave ablation (MWA) therapy of hepatocellular carcinoma (HCC). Methods Two hundred and fifty-one HCC lesions from 185 patients undergoing ultrasound-guided percutaneous MWA were studied by D-3D-CEUS and contrast-enhanced computed tomography(CECT) one month after ablation. Imaging results from two imaging modalities were evaluated independently to determine whether the treated lesions were ablated incompletely (residual lesion) or completely. The final diagnosis standard was biopsy pathology or clinical follow-up results. Results One hundred and eighty-five patients were successfully ablated completely. There was no serious complication observed. The final diagnosis standard identified 93.2%(234/251) of ablated lesions as complete ablation and 6.8% (17/251) as incomplete. With the final diagnosis as the reference standard, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of D-3D-CEUS and CECT were 82.4%(14/17) vs 88.2%(15/17), 98.3% (230/234) vs 97.4% (228/234), 77.8% (14/18) vs 71.4% (15/21), 98.7% (230/233) vs 99.1% (228/230), 97.2% (244/251) vs 96.8% (243/251), respectively. The difference between the D-3D-CEUS and CECT was not statistically significant(χ2=0.14, P=1.00). The consistency analysis showed that D-3D-CEUS and CECT were highly consistent with the final diagnosis standard (Kappa=0.81, P=0.00). Conclusions D-3D-CEUS imaging can be used for assessment of HCC MWA and be used as a useful supplement for CECT. Key words: Contrast-enhanced ultrasound, three-dimensional; Carcinoma, hepatocellular; Contrast media; Microwave/therapeutic use