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Objective:To investigate the clinical feasibility of three-dimensional contrast-enhanced ultrasound (3D-CEUS) in the quantitative assessment of blood perfusion of hepatocellular carcinoma (HCC).Methods:Between January 2020 and August 2021, 36 HCC patients (39 lesions in total) confirmed by pathology and clinical diagnosis without any treatment from Zhongshan Hospital, Fudan University were enrolled and underwent both 2D-CEUS and 3D-CEUS examinations. Each examination last for 150 s and all images were recorded, and then the data were analyzed. A region of interest was manually drawn along the margin of the whole tumor and then the time-intensity curve (TIC) generated. The following perfusion parameters were extracted: peak intensity (PI), peak time (TTP), ascending slope (AS), mean transit time (MTT) and area under the curve (AUC). After calculating the quality of fit (QOF) of the curve, the intraobserver agreement of the 3D-CEUS quantitative parameters obtained by the same doctor between two times were assessed, and the consistency of the 3D-CEUS and 2D-CEUS quantitative parameters was evaluated when QOF>75%. The differences of the quantitative parameters between different groups (divided by depth of 8 cm and necrosis rate of 50%, respectively) in 3D-CEUS were compared.Results:There were 38 lesions (97.4%, 38/39) with QOF>75% in 3D-CEUS. The intraobserver agreement was excellent, the intraclass correlation efficient(ICC) values was 0.85-0.99. The consistency of the time quantitative parameters (TTP and MTT) were high (the ICC values of 0.87 and 0.91), and the correlation of intensity quantitative parameters were substantial, the rs values were 0.71, 0.72 and 0.71. The differences in 3D-CEUS quantitative parameters of the two groups of lesions with different depths were statistically significant (all P<0.05); but there were no significant differences in quantitative parameters between the two groups with different necrosis rate (all P>0.05). Conclusions:Quantitative 3D-CEUS is an useful and creditable tool in evaluating the blood perfusion of HCC, especially when the depth of lesion was less than 8 cm.
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Objective To explore the clinical significance of dynamic 3-dimensional contrast-enhanced ultrasound (D-3D-CEUS) in assessing the efficacy of microwave ablation (MWA) therapy of hepatocellular carcinoma (HCC). Methods Two hundred and fifty-one HCC lesions from 185 patients undergoing ultrasound-guided percutaneous MWA were studied by D-3D-CEUS and contrast-enhanced computed tomography(CECT) one month after ablation.Imaging results from two imaging modalities were evaluated independently to determine whether the treated lesions were ablated incompletely (residual lesion) or completely.The final diagnosis standard was biopsy pathology or clinical follow-up results.Results One hundred and eighty-five patients were successfully ablated completely.There was no serious complication observed.The final diagnosis standard identified 93.2% (234/251) of ablated lesions as complete ablation and 6.8% (17/251) as incomplete. With the final diagnosis as the reference standard,the sensitivity, specificity,positive predictive value,negative predictive value,and accuracy of D-3D-CEUS and CECT were 82.4% (14/17) vs 88.2% (15/17),98.3% (230/234) vs 97.4% (228/234),77.8% (14/18) vs 71.4%(15/21),98.7% (230/233) vs 99.1% (228/230),97.2% (244/251) vs 96.8% (243/251),respectively. The difference between the D-3D-CEUS and CECT was not statistically significant(χ2=0.14,P =1.00).The consistency analysis showed that D-3D-CEUS and CECT were highly consistent with the final diagnosis standard (Kappa=0.81,P =0.00).Conclusions D-3D-CEUS imaging can be used for assessment of HCC MWA and be used as a useful supplement for CECT.
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Objective@#To evaluate the feasibility of quantitative analysis of dynamic 3-dimensional contrast-enhanced ultrasound (3D-CEUS) for treatment effects of microwave coagulation on xenograft tumors in nude mice.@*Methods@#BALB/c nude mice transplanted of HepG2 cells were divided into treatment group(n=16) and control group(n=16). The tumors were treated by incomplete microwave coagulation in the treatment group when their maximum diameters were about 0.8~1.0 cm. The baseline ultrasound and dynamic 3D-CEUS were performed on 1 d before treatment, 3 d after treatment, 7 d after treatment and 14 d after treatment. Time-intensity curves of the tumors were obtained by fitting. The quantitative parameters were also obtained, including peak intensity (PI), time to peak (TTP), mean transit time (MTT), slope (S), area under the curve (AUC), area under the curve of wash-in (AWI), and area under the curve of wash-out (AWO).@*Results@#There were significant differences(P=0.029) between the two groups in PI, S, AUC, AWO on 3 d and 14 d. The differences in other parameters were not statistically significant (P>0.05). On 1 d before treatment and 7 d after treatment, none of the parameters had statistically significant difference (P>0.05).@*Conclusions@#The quantitative analysis of dynamic 3D-CEUS is feasible to assess the treatment response on xenograft tumors in nude mice.