Quantitative analysis of contrast-enhanced ultrasonography in rat models of hepatic acute graft-versus-host disease

Abstract

Background Hepatic acute graft-versus-host disease (aGVHD) is a major life-threatening complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT). We hypothesized that contrast-enhanced ultrasound (CEUS) could serve as a new imaging biomarker in early diagnosis of hepatic aGVHD by detecting liver microcirculation. Methods Thirty Wistar rats received allo-HSCT were finally included after excluding 9 rats, and they were randomly divided into 5 groups (1- to 5-week groups, 6 per group). Six rats were used for the control group without any intervention. We observed the clinical scores, serum liver enzyme levels and liver CEUS parameters of rats in each group. Hepatic aGVHD was finally confirmed by histopathologic analysis. The diagnostic performance of CEUS parameters in detecting GVHD was evaluated by comparing the area under the receiver operating curve (AUC) values. Results After HSCT, the rats developed ruffling of fur, maculopapular rash, weight loss, accompanied by increased clinical scores. Serum liver enzymes were significantly higher than those in the control group from the third week, especially alkaline phosphatase, while CEUS parameters, peak intensity (PI) and mean transit time (MTT), changed in the second week (P<0.001). Compared with non-aGVHD group, the PI was significantly decreased while time to peak and MTT were prolonged in aGVHD group. CEUS parameters were more strongly correlated with pathological grade than serology. PI was an independent predictor for hepatic aGVHD. The AUC of CEUS parameters for diagnosing hepatic aGVHD was 0.933 (95% CI: 0.779–0.992), which was higher than that of clinical scores (AUC =0.748, 95% CI: 0.557–0.888, P=0.032) and serological markers (AUC =0.902, 95% CI: 0.737–0.980, P=0.694). Conclusions CEUS exhibits promising applications as a quantitative method to detect hepatic aGVHD and early liver damage.

Treatment response assessment to chemotherapy with bevacizumab for colorectal liver metastasis by contrast-enhanced ultrasound

“…Contrast-enhanced ultrasound (CEUS) is the exclusive imaging technique that has a pure intra-vascular contrast agent, which effectively disregards diffusion and leakage into the mesenchyma ( 16 ). Promising results have been achieved from studies on CEUS perfusion parameters in revealing the change of vascularity in different tumors under treatment, such as gastrointestinal stromal tumor, renal cell carcinoma, and hepatocellular carcinoma (HCC) ( 17 ).…”