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3D versus 2D contrast-enhanced sonography in the evaluation of therapeutic response of hepatocellular carcinoma after locoregional therapies: preliminary findings

  • ABDOMINAL RADIOLOGY
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Abstract

Objective

To investigate diagnostic performance of 3D contrast-enhanced ultrasound (CEUS) compared with 2D CEUS in the assessment of therapeutic response of hepatocellular carcinoma (HCC) treated with locoregional therapies (LRT).

Materials and methods

Twenty-three consecutive patients (13 men and 10 women; mean age 65.5 years) with 23 HCCs (size range 1.2–7.2 cm; mean size 2.9 ± 1.4 cm) treated by means of radiofrequency ablation (RFA n = 9), transarterial chemoembolization (TACE n = 8), combined RFA and TACE (n = 3), percutaneous alcoholization (n = 2), and wedge resection (n = 1) underwent 2D and 3D CEUS 1 month (30 ± 2 days) after treatment. Magnetic resonance (n = 17) and computed tomography (n = 6) acted as standard of reference (SOR). Two radiologists assessed the absence (complete response CR) or presence (residual tumor RT) of any nodular arterially enhancing area within or along the margin of the treated HCC.

Results

Both 2D and 3D CEUS observed CR in 10/23 (43.5 %) HCCs and RT in 11/23 (47.8 %) HCCs. In 1/23 (4.3 %) HCC, RT was documented by SOR and 2D CEUS, but it was not appreciable at 3D CEUS. In 1/23 (4.3 %) HCC, the presence of peripheral residual tumor was suspected by both 2D and 3D CEUS, but it was not confirmed by SOR. No statistically significant difference between 2D and 3D CEUS in depicting either CR or RT was found (p > 0.05). Sensitivity, specificity, positive and negative predictive values, and accuracy of 3D CEUS were 91.7 % [95 % confidence interval (CI) 0.760–1.073], 90.9 % (95 % CI 0.739–1.079), 91.7, 90.9, and 91.3 %, respectively.

Conclusion

2D and 3D CEUS provided similar diagnostic performance in the assessment of therapeutic response of HCC treated with LRT.

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References

  1. Dodd GD 3rd, Soulen MC, Kane RA et al (2000) Minimally invasive treatment of malignant hepatic tumors: at the threshold of a major breakthrough. Radiographics 20:9–27

    Article  PubMed  Google Scholar 

  2. Taibbi A, Furlan A, Sandonato L et al (2012) Imaging findings of liver resection using a bipolar radiofrequency electrosurgical device-initial observations. Eur J Radiol 81:663–670

    Article  PubMed  Google Scholar 

  3. Raza A, Sood GK (2014) Hepatocellular carcinoma review: current treatment, and evidence-based medicine. World J Gastroenterol 20:4115–4127

    Article  PubMed Central  PubMed  Google Scholar 

  4. Sala M, Llovet JM, Vilana R et al (2004) Initial response to percutaneous ablation predicts survival in patients with hepatocellular carcinoma. Hepatology 40:1352–1360

    Article  PubMed  Google Scholar 

  5. El-Gazzaz G, Sourianarayanane A, Menon KV et al (2013) Radiologic-histological correlation of hepatocellular carcinoma treated via pre-liver transplant locoregional therapies. Hepatobiliary Pancreat Dis Int 12:34–41

    Article  PubMed  Google Scholar 

  6. Bartolotta TV, Taibbi A, Midiri M, De Maria M (2008) Hepatocellular cancer response to radiofrequency tumor ablation: contrast-enhanced ultrasound. Abdom Imaging 33:501–511

    Article  PubMed  Google Scholar 

  7. Luo W, Numata K, Morimoto M et al (2010) Role of Sonazoid-enhanced three-dimensional ultrasonography in the evaluation of percutaneous radiofrequency ablation of hepatocellular carcinoma. Eur J Radiol 75:91–97

    Article  PubMed  Google Scholar 

  8. Leen E, Kumar S, Khan SA et al (2009) Contrast-enhanced 3D ultrasound in the radiofrequency ablation of liver tumors. World J Gastroenterol 15:289–299

    Article  PubMed Central  PubMed  Google Scholar 

  9. World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects. http://www.wma.net/en/30publications/10policies/b3/. Accessed 10 Oct 2014

  10. Yaghmai V, Besa C, Kim E et al (2013) Imaging assessment of hepatocellular carcinoma response to locoregional and systemic therapy. AJR 201:80–96

    Article  PubMed  Google Scholar 

  11. Catalano O, Lobianco R, Esposito M et al (2001) Hepatocellular carcinoma recurrence after percutaneous ablation therapy: helical CT patterns. Abdom Imaging 26:375–383

    Article  CAS  PubMed  Google Scholar 

  12. Limanond P, Zimmerman P, Raman SS et al (2003) Interpretation of CT and MRI after radiofrequency ablation of hepatic malignancies. AJR 181:1635–1640

    Article  PubMed  Google Scholar 

  13. Xu HX, Lu MD, Xie XH et al (2009) Three-dimensional contrast-enhanced ultrasound of the liver: experience of 92 cases. Ultrasonics 49:377–385

    Article  PubMed  Google Scholar 

  14. Luo W, Numata K, Morimoto M et al (2009) Three-dimensional contrast-enhanced sonography of vascular patterns of focal liver tumors: pilot study of visualization methods. AJR 192:165–173

    Article  PubMed  Google Scholar 

  15. Luo W, Numata K, Morimoto M et al (2009) Focal liver tumors: characterization with 3D perflubutane microbubble contrast agent-enhanced US versus 3D contrast-enhanced multidetector CT. Radiology 251:287–295

    Article  PubMed  Google Scholar 

  16. Luo W, Numata K, Morimoto M et al (2010) Role of Sonazoid-enhanced three-dimensional ultrasonography in the evaluation of percutaneous radiofrequency ablation of hepatocellular carcinoma. Eur J Radiol 75:91–97

    Article  PubMed  Google Scholar 

  17. Bartolotta TV, Taibbi A, Matranga D et al (2012) Incidence of new foci of hepatocellular carcinoma after radiofrequency ablation: role of multidetector CT. Radiol Med 117:739–748

    Article  CAS  PubMed  Google Scholar 

  18. Giangregorio F, Comparato G, Marinone MG et al (2009) Imaging detection of new HCCs in cirrhotic patients treated with different techniques: comparison of conventional US, spiral CT, and 3-dimensional contrast-enhanced US with the Navigator technique (Nav 3D CEUS) J. Ultrasound 12:12–21

    Article  CAS  Google Scholar 

  19. Catalano O, Sandomenico F, Nunziata A et al (2007) Transient hepatic echogenicity difference on contrast-enhanced ultrasonography: sonographic sign and pitfall. J Ultrasound Med 26:337–345

    PubMed  Google Scholar 

  20. Zheng S-G, Xu H-X, Liu L-N et al (2014) Management of hepatocellular carcinoma: the role of contrast-enhanced ultrasound. World J Radiol 6:7–14

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare no conflict of interest.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Correspondence to Tommaso Vincenzo Bartolotta.

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Bartolotta, T.V., Taibbi, A., Matranga, D. et al. 3D versus 2D contrast-enhanced sonography in the evaluation of therapeutic response of hepatocellular carcinoma after locoregional therapies: preliminary findings. Radiol med 120, 695–704 (2015). https://doi.org/10.1007/s11547-015-0514-4

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  • DOI: https://doi.org/10.1007/s11547-015-0514-4

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