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

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

Contrast enhanced ultrasonography in assessing the treatment response to transarterial chemoembolization in patients with hepatocellular carcinoma.

“…In one recent study 2D and 3D CEUS 1 month (30±2 days) after treatment were compared using MRI and CT as standard of reference. No statistically significant difference between 2D and 3D CEUS in depicting either complete response or residual tumor was found [29]. It should be noted that these are preliminary results and in order to show the theoretical superiority of 3 D CEUS new data is mandatory needed.…”

Usefulness of contrast enhanced ultrasound in monitoring therapeutic response after hepatocellular carcinoma treatment

“…More recently, three-dimensional CEUS technique (3D CEUS) has been reported to improve the study of tumour vascularity, thus allowing the response evaluation of HCC treatments in the three orthogonal planes. Nevertheless, it has been suggested that the spatial resolution of the current 3D probes may be limited as 3D CEUS provided similar diagnostic performance compared to conventional CEUS in the assessment of therapeutic response of HCC treated with ablative treatments [59] .…”

The Application Comparison of Contrast-Enhanced Ultrasound and Contrast-Enhanced Computed Tomography in Radiofrequency Ablation Treatment for Hepatocellular Carcinoma

“…18 The complete ablation rate of the CEUS group was significantly higher than that of the CECT group, which might benefit from immediate postoperative examination, assessment of ablation effects, as well as the rapid and repeated ablations. 19 There was a congestion and edema region appearing around the tissues undergoing RFA and it is hard to distinguish the congestion zone from tumor residuals through the CECT. The RFA effects could only be assessed 1 month after the congestion zone had disappeared.…”