Comparison of contrast-enhanced ultrasound and contrast-enhanced computed tomography in evaluating the treatment response to transcatheter arterial chemoembolization of hepatocellular carcinoma using modified RECIST.

PURPOSE: We aimed to compare contrast-enhanced ultrasound (CEUS) with contrast-enhanced computed tomography (CECT) for evaluating the treatment response to transcatheter arterial chemoembolization (TACE) of hepatocellular carcinoma (HCC).

MATERIALS AND METHODS: Treatment responses of 130 patients who underwent TACE were evaluated by CEUS and CECT. We initially compared the abilities of CEUS and CECT to detect residual tumour, which were confirmed by histology or angiography. Then, we compared the tumour response to TACE assessed by CEUS and CECT, according to Modified Response Evaluation Criteria in Solid Tumours (mRECIST).

RESULTS: The sensitivity and accuracy of detecting residual tumour by CEUS vs. CECT were 95.9 % vs. 76.2 % (p < 0.001) and 96.2 % vs. 77.7 % (p < 0.001), respectively. For target lesions, 13 patients were observed as complete response (CR) by CEUS, compared to 36 by CECT (p < 0.001). For nontarget lesions, 12 patients were observed as CR by CEUS, compared to 22 by CECT (p = 0.006). For overall response, eight patients were observed as CR by CEUS, compared to 31 by CECT (p < 0.001).

CONCLUSION: The diagnostic performance of CEUS was superior to CECT for detecting residual tumour after TACE. In clinical, CEUS should be recommended as an optional procedure for assessing the tumour response to TACE.

KEY POINTS: • The mRECIST are widely applied for evaluating the response of HCC. • Imaging method has been applied to assess the therapeutic response to TACE. • The diagnostic performance of CEUS was superior to CECT for residual tumours. • CEUS can be a valuable method for assessing tumour response to TACE.