Comparison of Contrast-Enhanced Ultrasound and CT/MRI in Transarterial Chemoembolization and Hepatic Arterial Infusion Chemotherapy.

OBJECTIVE

Early assessment of treatment response following locoregional therapy remains a challenge in managing hepatocellular carcinoma (HCC). Recent advancements in contrast-enhanced ultrasound (CEUS) have demonstrated significant potential in the early assessment of tumor viability. This study compared the evaluation capabilities of CEUS and CT/MRI in assessing treatment response to hepatic arterial infusion chemotherapy (HAIC) and transarterial chemoembolization (TACE).

MATERIALS AND

METHODS

This study included patients who had received TACE or HAIC between 2010 and 2024. 1:1 propensity score matching was used to reduce confounding bias between the TACE and HAIC groups. A comparative analysis was carried out using pathological complete response of treated lesions as the reference standard to assess the diagnostic performance of CEUS and CT/MRI across different treatment strategies.

RESULTS

A total of 154 patients with 167 observations were ultimately included. In the propensity score matching cohort, CEUS and CT/MRI demonstrated similar diagnostic performance, with no significant differences in sensitivity (96% vs 92%, p = 0.07) or specificity (67% vs 57%, p > 0.99). Additionally, CEUS showed comparable results between HAIC and TACE groups in both sensitivity (98% vs 94%, p = 0.61) and specificity (50% vs 77%, p = 0.35).

CONCLUSION

CEUS demonstrated no significant difference in diagnostic performance compared with CT/MRI in evaluating HCC treatment response to HAIC and TACE.