Fibroscan and Doppler Ultrasonography in the Assessment of Hepatocellular Carcinoma Interventional Therapy

Kariman Elkasrawy,Sabry Abou-Saif,Amr El-Badry,Nehad Hawash,Mona Shehata

doi:10.11648/j.ijmi.20210901.14

Kariman Elkasrawy, Sabry Abou-Saif + Show 3 more

Open Access

https://doi.org/10.11648/j.ijmi.20210901.14

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Abstract

Background: studying hepatocellular carcinoma (HCC) interventional therapy by a simple, noninvasive techniquesthat doesn’t require contrast material is valuable. Doppler ultrasound and fibroscanimaging gives anon-invasive demonstration of blood flow by real time observation and the fibrosis burden which can be related to HCC recurrence. Objectives: The aim of this study was to evaluate the role of fibroscan and Doppler ultrasonography in the assessment of efficacy and safety of hepatocellular carcinoma interventional therapy. Methods: this prospective study was conducted on HCC patients undergoing interventional therapy. The vasculature of both the liver and the focal lesion were assessed using Doppler ultrasonography and liver fibrosis burden was assessed usingfibroscan and compared to CT results. These tests were done one month before and 6 months after intervention. A cut off point of liver stiffness measurement (LSM) at which well ablation can be predicted was evaluated by receiver operating characteristic (ROC) curve. Results: Enrollment of 56 Egyptian patients was done. Portal hypertension (PHT) indices increased significantly after transarterial chemoembolization (TACE) and while did not after microwave ablation (MWA) indicating the safety of MWA. The vascularity of hepatocellular carcinoma point out areas of residual tumor. The TACE group showed high statistically significant increase in LSM after intervention (P<0.001). ROC curve analysis showed that LSM at cut off value ≤ 35.2 KPa can predict good ablation of HCC with a sensitivity 78.38% and specificity 70.83%. Conclusion: TACE is associated with increased portal hypertension indices than MWA and Doppler parameters is a non-invasive simple technique that can be used for follow up of HCC patients after interventional therapy. Also liver stiffness measurement can be used as a good predictor of good ablation of HCC.

Highlights

Hepatocellular carcinoma (HCC) is estimated to be the sixth most common malignancy, the third leading cause of cancerrelated mortality worldwide and the fourth most common malignancy in Egypt [1, 2]
Surgical Resection is generally recommended for HCC, but it is indicated only for patients with early is of liver fibrosis and well preserved liver function [3]
From 108 patients examined to be included in this study 56 individuals were enrolled and we categorized them according to HCC ablative therapy they had receivedin 2 groups: Group (I): Included 31 patients with HCC who had undergone transarterial chemoembolization (TACE) as a treatment modality of HCC

Summary

Introduction

Hepatocellular carcinoma (HCC) is estimated to be the sixth most common malignancy, the third leading cause of cancerrelated mortality worldwide and the fourth most common malignancy in Egypt [1, 2]. A background of chronic liver disease or cirrhosis is present in 70–90% of cases who develop HCC. Surgical Resection is generally recommended for HCC, but it is indicated only for patients with early is of liver fibrosis and well preserved liver function [3]. In spite of advances in screening, diagnosing, and treating HCC, it is considered one of the most serious tumors due to its high rate of recurrence after treatment and its spread to other organs [4]. Liver transplantation and surgical resection are considered to be the gold standard of HCC treatment, their invasive nature made them unsuitable for most of the HCC patients to which locoregional therapy is favourable due to its high safety and efficacy [5]

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