Application value of ultrasound TIC curve in the evaluation of ablation effect of liver tumors

Abstract

ObjectiveTo evaluate the efficacy of ablation of hepatocellular carcinoma (HCC) and the diagnostic value of new intrahepatic nodules after ablation by studying the time-intensity curve (TIC) of contrast-enhanced ultrasound (CEUS), Maximize the survival time and quality of life of patients.so as to make treatment plans as early as possible and extend the survival time and quality of life of patients to the greatest extent. MethodsA total of 59 nodules were selected from 42 clinically confirmed HCC patients who planned to undergo ultrasound-guided microwave ablation in our hospital from October 2021 to October 2022. Among them, 31 were males and 11 were females, aged 38–72 years, with an average age of 56.7 ± 9.6 years. For all lesions included in the study, CEUS examination was performed before ablation and TIC was fitted. The patients were examined by routine B-ultrasound, CEUS alone, CEUS combined with TIC at 1 month, 3 months and 6 months after ablation. At the same time, CEUS alone and CEUS combined with TIC were performed for all new nodules found in the liver under conventional B-ultrasonography. The diagnostic efficacy of CEUS alone and CEUS combined with TIC on ablation and new nodules in the liver were compared and analyzed. At least two enhanced imaging tests (CEUS, enhanced CT, or enhanced MRI) plus relevant laboratory tests were used as the gold standard. Meanwhile, the quantitative parameters of recurrent lesions and TIC nodules in liver were compared with the surrounding normal tissues before and after surgery. Results(1) When evaluating the efficacy of ultrasound-guided microwave ablation, the specificity, accuracy and positive prediction rate of CEUS combined with TIC diagnosis group were lower than those of CEUS alone, and the difference was statistically significant; (2) The sensitivity, accuracy and negative predictive rate of CEUS combined with TIC in the diagnosis of new intrahepatic nodules after intrahepatic ablation were higher than those of CEUS alone, but the difference was not statistically significant; (3)The TIC peak time of primary hepatocellular carcinoma (HCC), local recurrence of HCC after microwave ablation and intrahepatic recurrence of HCC after ablation was shorter than the surrounding normal liver parenchyma, and the difference was statistically significant, while the slope of curve rise was larger than the surrounding normal liver parenchyma, and the difference was statistically significant.) ConclusionTIC is not suitable for evaluating the efficacy of ultrasound-guided microwave ablation for primary hepatocellular carcinoma, as TIC can significantly increase the false positive rate.For the diagnosis of new nodules in liver after microwave therapy of hepatocellular carcinoma, CEUS combined with TIC method is suitable, which can improve the diagnostic efficiency of the disease. At the same time, it was found in our study that the peak time of primary hepatocellular carcinoma, local recurrent liver cancer foci after microwave ablation, and intrahepatic recurrent liver cancer after ablation was less than that of surrounding normal liver parenchyma, and the upward slope of the curve was greater than that of surrounding normal liver parenchyma. Therefore, in the CEUS diagnosis of intrahepatic space-occupying lesions, the method of quantitative parameters can be adopted to quantitatively evaluate the nature of the lesions in order to obtain more accurate results.