[Application value of real-time three-dimensional contrast-enhanced ultrasound for morphological assessing of hepatocellular carcinoma before radiofrequency ablation treatment]

Objective: To investigate the evaluating ability of real-time three-dimensional contrast-enhanced ultrasound (RT-3D-CEUS) for morphology of hepatocellular carcinoma (HCC) before radiofrequency ablation (RFA) treatment. Methods: Sixty patients with 88 targeted lesions were enroll in this study, who have received RFA in Hangzhou Xiasha Hospital. The pretreatment imaging data of CEUS and RT-3D-CEUS were retrospective analysis. Morphological features were assessed according to the size and shape of the lesions, and were compared between two modalities with the post-treatment response as the reference standard. Results: The size of lesion measured by CEUS and RT-3D-CEUS was similar in 70 out of 88 lesions (group A). In the other 18 lesions, the size measured by RT-3D-CEUS was larger than that by CEUS (group B). For the shape analysis, 38 lesions were spheroid by CEUS and 34 lesions by RT-3D-CEUS; 47 lesions were oval by CEUS and 41 lesions by RT-3D-CEUS; 3 lesions were irregular by CEUS and 13 lesions by RT-3D-CEUS. There were 78 lesions which shape assessed by two modalities consistently (group A'), and the other 10 lesions with inconsistent shape by two modalities (group B'). Three months follow-up results showed that 4 lesions appeared tumor residue (5.7%) in group A' and 6 lesions (33.3%) in group B'. There was significant difference between these two groups (P=0.004). In the group A', there were 6 lesions (7.7%) showed tumor residue, and 4 lesions (40.0%) in group B'. The difference between these two groups was also significant (P=0.012). Conclusion: RT-3D-CEUS could be used to assess the size and shape of HCC accurately which is associated with the response of RFA.