Dynamic 3D-CEUS Research Articles

Early evaluation of treatment response to transarterial chemoembolization in patients with advanced hepatocellular carcinoma: The role of dynamic three-dimensional contrast-enhanced ultrasound.

Dynamic three-dimensional contrast-enhanced ultrasound (3D-CEUS) with quantitative analysis is available in recent years. It can reduce the quantitative sampling error caused by the inconsistency of different sections in order to evaluate local treatment response of hepatocellular carcinoma (HCC) accurately. To investigate the value of dynamic 3D-CEUS in evaluating the early response to transarterial chemoembolization (TACE) treatment in patients with advanced HCC lesions. In this prospective study, both two-dimensional (2D) CEUS and dynamic 3D-CEUS were performed on 40 HCC patients who scheduled for TACE at baseline (T0) and 1-3 days (T1) after treatment. Tumor microvascular perfusion changes were assessed by CEUS time-intensity curve (TIC) and quantitative parameters. According to contrast-enhanced computed tomography (CT) and magnetic resonance (MR) imaging 1 month after treatment results, patients were divided into responders and non-responders groups. The changes of perfusion parameters of both 2D-CEUS and 3D-CEUS were compared between responders and non-responders groups before and after TACE treatment. Before and after TACE treatment, no significant difference in maximum diameter of HCC lesions between the two groups could be found. There were more significant differences and ratios of perfusion parameters in 3D-CEUS quantitative analysis than in 2D-CEUS. The mutual significant differences and ratios of 2D-CEUS and 3D-CEUS included peak intensity (PI) difference, PI ratio, ratio of area under the curve (A), ratio of area under the wash-out part (AWO) and slope (S) difference. The former 4 corresponding parameters were better on 3D-CEUS than on 2D-CEUS. Dynamic 3D-CEUS can be used as a potential imaging method to evaluate early treatment response to TACE in advanced HCC patients.

Dynamic Three-Dimensional Contrast-Enhanced Ultrasound to Predict Therapeutic Response of Radiofrequency Ablation in Hepatocellular Carcinoma: Preliminary Findings.

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.

Comparison of 2-dimensional and 3-dimensional contrast-enhanced ultrasound for quantitative analysis in liver neoplasms

Objective To evaluate the correlation and consistency of dynamic three-dimensional contrast-enhanced ultrasonography (3D-CEUS) and two-dimensional contrast-enhanced ultrasonography (2D-CEUS) in the time-intensity curve (TIC) parameters of quantitative analysis in liver neoplasms. Methods Thirty patients were examined with 2D-CEUS and dynamic 3D-CEUS.The dynamic raw data were analyzed by quantitative analysis software. The regions of interest were manually selected around the entire lesion; TIC curves were generated and fitted respectively. Quality of fit (QOF) was used to evaluate the degree of fit between the fitted curve and the initial curve. The corresponding 2D-CEUS and 3D-CEUS quantitative parameters of the same lesion were compared, including peak intensity (PI), slope (S), area under curve (AUC), time to peak (TTP) and mean transit time (MTT). The correlation of the intensity-related quantitative parameters and the consistency of the time-related quantitative parameters were analyzed between the two kinds of CEUS. Results The consistency of time related quantitative parameters, including MTT and TTP, were 0.97 and 0.96, and the correlation were 0.94 and 0.93. The correlation coefficients of S, PI and AUC were 0.92, 0.72 and 0.65, respectively. Conclusions The quantitative results of 3D-CEUS are stable and reliable, and have fair concordance with 2D-CEUS. Dynamic 3D-CEUS can be used for clinical evaluation of the blood perfusion of liver neoplasms. Key words: Contrast-enhanced ultrasonography; Liver neoplasms; Quantitative analysis

Preliminary application of quantitative analysis of focal liver lesions with dynamic 3D contrast-enhanced ultrasonography

Objective To assess the ability of three-dimensional contrast-enhanced ultrasonography (3D-CEUS) and quantitative analysis in differential diagnosis of focal liver lesions (FLL). Methods The quantitative analysis technique was used to deal with the dynamic 3D-CEUS raw data of FLL, which were confirmed by clinical or pathological diagnosis. The corresponding time-intensity curve and parameters were obtained. The parameters were compared to confirm whether there existed any difference in the parameters between benign and malignant FLL. Results Seventy-three FLL were enrolled including 59 malignant and 14 benign lesions. The differences of the parameters between benign and malignant groups were statistically significant, including area under the curve (A)(169.58±95.46 vs 71.26±64.13), area under the curve of wash-in (AWI)(22.84±18.37 vs 9.96±10.01), and area under the curve of wash-out (AWO)(146.73±82.03 vs 61.29±55.06)(all P 0.05). Conclusions The quantitative analysis can be used to identify benign and malignant FLLs on 3D-CEUS. Key words: Ultrasonography, three-dimensional; Quantitative analysis; Focal liver lesions

Clinical value of dynamic 3-dimensional contrast-enhanced ultrasound imaging for the assessment of hepatocellular carcinoma ablation

ObjectiveThe aim of the study was to investigate the performance of dynamic 3-dimensional contrast-enhanced ultrasound (3D-CEUS) on assessment of efficacy of local ablation therapy of hepatocellular carcinoma (HCC) with contrast-enhanced computed tomography (CT) as reference standard. MethodsEighty-nine HCC lesions from 75 patients undergoing ultrasound-guided percutaneous thermal ablation or chemical ablation were studied by both dynamic 3D-CEUS and contrast-enhanced CT 1month after ablation. Imaging results from two imaging modalities were evaluated independently by experienced readers to determine whether the treated lesions were ablated incompletely (residual unablated tumor) or completely. Sensitivity, specificity, positive and negative predictive values, and accuracy to identify incomplete ablation were calculated for dynamic 3D-CEUS imaging with contrast-enhanced CT as reference standard. ResultsContrast-enhanced CT reported that 80.9% (72/89) of all the treated lesions were completely ablated and 19.1% (17/89) were incompletely ablated. The dynamic 3D-CEUS identified 82.0% (73/89) and 18.0% (16/89) of lesions as completely and incompletely ablated, respectively. With contrast-enhanced CT as the reference standard, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of dynamic 3D-CEUS for identifying residual unablated tumor were 88.2% (15/17), 98.6% (71/72), 93.8% (15/16), 97.3% (71/73), and 96.6% (86/89), respectively. The Kappa value for identifying residual unablated tumor between contrast-enhanced CT and dynamic 3D-CEUS was 0.89. ConclusionsDynamic 3D-CEUS is highly consistent with contrast-enhanced CT in assessment of efficacy of HCC ablation and has potential to serve as an alternative to contrast-enhanced CT in the follow-up assessment after HCC ablation.

Comparison of enhancement features of hepatic tumors between dynamic three-dimensional and two-dimensional contrast-enhanced ultrasonography

Objective To investigate the enhancement features of hepatic tumors between dynamic three-dimensional contrast-enhanced ultrasonography (3D-CEUS) and two-dimensional contrast-enhanced ultrasonography (2D-CEUS).Methods Totally,65 patients with 67 focal liver lesions were examined with 2D-CEUS and dynamic 3D-CEUS.Enhancement patterns,sharpness or three-dimensional effect in different phases,definition of blood vessel in arterial phase and spatial relationships of tumor and vascularity of different hepatic tumors on the two imaging modes were compared statistically,the value of two modes in differential diagnosis of hepatic tumors was also evaluated.Results Dynamic 3D-CEUS was similar to 2DCEUS with respect to enhancement patterns,sharpness or three-dimensional effect of tumor in arterial and portal phases( P ＞0.05).And there was no significant difference between the value of dynamic 3D-CEUS and 2D-CEUS in differential diagnosis of hepatic tumors:the sensitivity,specificity,positive predictive value and negative predictive value were 98.0％,81.3 ％,94.3 ％ and 92.9％ for 3D-CEUS,and were 96.1％,81.3％,94.2％ and 86.7％ for 2D-CEUS,respectively.However,3D-CEUS was superior to 2D-CEUS in the display of definition of blood vessel in arterial phase,and spatial relationships of hepatic tumor and vascularity( P ＜0.05).Conclusions Dynamic 3D-CEUS is a useful technique in the differential diagnosis of hepatic tumors as well as 2D-CEUS,and dynamic 3D-CEUS displays the spatial relationship of hepatic tumors and vascularity more visually and effectively,which provides additional information in the diagnosis and therapy of hepatic tumors. Key words: Ultrasonography,three dimensional; Microbubbles; Liver neoplasms