Shashibala Paul MBBS,PhD, Abstract Co-Author: Nothing to Disclose

Vishnubhatla Sreenivas, Abstract Co-Author: Nothing to Disclose

Ekta Dhamija MD, Presenter: Nothing to Disclose

Hanish Sharma, Abstract Co-Author: Nothing to Disclose

Shivanand Ramachandra Gamanagatti MBBS, MD, Abstract Co-Author: Nothing to Disclose

Subrat K. Acharya MD, Abstract Co-Author: Nothing to Disclose

To evaluate the tumor response following locoregional therapies in patients with Hepatocellular carcinoma(HCC) by contrast- enhanced ultrasound (CEUS) and compare the diagnostic accuracy of response detection of CEUS with multiphasic CT(MPCT).

HCC patients treated with locoregional therapies [Trans-arterial chemoembolization(TACE) / Radiofrequency ablation (RFA)  /acetic acid ablation (PAI) or any combination], were enrolled. At 4 weeks post-treatment, CEUS of the liver was done using SonoVue contrast media.Contrast enhanced multiphasic CT (MPCT) and Magnetic resonance imaging (MRI) liver were also done.All three modalities of CEUS, MPCT and MRI were done not more than 2 weeks apart. Tumor response of the largest mass per patient was assessed on all the three imaging modalities. Enhancing tissue in the treated tumor area on CEUS/MPCT/MRI was termed as residual disease. Types of residual disease was labelled as peripheral nodular, homogenous, heterogenous. Central or rim enhancement depending upon the location. Sensitivity, specificity, positive and negative predictive values of CEUS in detecting residual was estimated and compared with that of MPCT, taking MRI as the gold standard

Ninety six patients (mean age 53.5 years, males 81,females15), with 102 HCC , treated with TACE(61), RFA(11), PAI(18) and TACE plus PAI(6 ), were included. Mean mass size was 4.6 +2.5cm (range 0.8-15.6 cm).Residual disease was seen in 65/102(63.7%) masses on CEUS. Different patterns were - peripheral nodular 43.1%, heterogenous35.4% homogenous 16.9%, central 3.1% and rim enhancement in 1.5%. Seventy two masses could be evaluated on all three modalities. Sensitivity, specificity, PPV and NPV of CEUS was 85.7%, 76.7%, 83.7% and 79.3% compared with 40.5%, 90%, 85% and 51.9% respectively on MPCT. 

CEUS has a higher diagnostic accuracy compared with MPCTin detection of residual disease in HCC patients treated with locoregional therapies and peripheral nodular is the commonest pattern seen.

Evaluation of the diagnostic accuracy of CEUS in assessment of tumor response following locoregional therapies is important because if CEUS results are encouraging, use of MPCT could be circumvented.

Paul, S, Sreenivas, V, Dhamija, E, Sharma, H, Gamanagatti, S, Acharya, S, Assessment of Tumor Response Following Loco-regional Therapies in Patients of Hepatocellular Carcinoma using Contrast-enhanced Ultrasound and Compare Its Diagnostic Accuracy with Multiphasic CT.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045685.html