Abstract
Background & Aims To investigate the value of dynamic three-dimensional contrast-enhanced ultrasound (3D-CEUS) in the assessment of therapeutic response of hepatocellular carcinoma (HCC) treated with radiofrequency ablation (RFA). Methods Forty-two patients (31 men and 11 women; mean age (52.1 ± 13.1 years)) with 42 clinical diagnosed HCC lesions (size range 14-48 mm; mean size 28.4 ± 9.9 mm) treated by RFA were included. All patients underwent two-dimensional contrast-enhanced ultrasound (2D-CEUS) and 3D-CEUS 1 month after treatment. Two radiologists assessed the absence (complete response, CR) or presence (residual tumor, RT) of any arterially hyperenhancing nodules within or along the margin of the treated HCC lesions. Complete response on magnetic resonance (MR) imaging acted as standard of reference (SOR). Results After RFA treatment, 3D-CEUS was successfully conducted in 34 HCC lesions. CR was observed on both 2D-CEUS and 3D-CEUS in 25/42 (59.5%) HCC and RT in 6/42 (14.3%) HCC lesions. In 3/42 (7.1%) HCC lesion, RT was documented by SOR and 3D-CEUS, but it was not appreciable at 2D-CEUS. In 3/42 (7.1%) HCC lesion, the presence of peripheral RT was suspected by both 2D-CEUS and 3D-CEUS, but it was not confirmed by SOR. No statistically significant difference between 2D-CEUS and 3D-CEUS in depicting either CR or RT was found (P = 0.25). Combined with dynamic 3D-CEUS, the diagnostic accuracy was improved from 85.7% to 92.9%. Conclusions 3D-CEUS might be helpful in better diagnostic performance in the assessment of therapeutic response of HCC treated after RFA.
Highlights
Various nonsurgical local minimal invasive treatment options, including radiofrequency ablation (RFA), transarterial chemoembolization (TACE), and percutaneous alcoholization, have emerged as valid alternative treatments in patients with hepatocellular carcinoma (HCC) [1, 2]
Change in tumor size has been used in clinical practice to determine the treatment response according to the World Health Organization criteria and the Response Evaluation Criteria in Solid Tumors (RECIST) [7]
The purpose of our current study is to investigate the diagnostic performance of dynamic 3D-CEUS compared with 2D-CEUS in the assessment of therapeutic response of HCC treated with RFA
Summary
Various nonsurgical local minimal invasive treatment options, including radiofrequency ablation (RFA), transarterial chemoembolization (TACE), and percutaneous alcoholization, have emerged as valid alternative treatments in patients with hepatocellular carcinoma (HCC) [1, 2]. Medical imaging plays an important role in the evaluation of RFA treatment response of HCC patients. Changes in tumor size and tumor vascularity are the very parameters in evaluation of the therapeutic response. To investigate the value of dynamic three-dimensional contrast-enhanced ultrasound (3D-CEUS) in the assessment of therapeutic response of hepatocellular carcinoma (HCC) treated with radiofrequency ablation (RFA). Fortytwo patients (31 men and 11 women; mean age (52.1 ± 13.1 years)) with 42 clinical diagnosed HCC lesions (size range 14-48 mm; mean size 28.4 ± 9.9 mm) treated by RFA were included. Two radiologists assessed the absence (complete response, CR) or presence (residual tumor, RT) of any arterially hyperenhancing nodules within or along the margin of the treated HCC lesions.
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