Advances in the diagnosis and treatment of hepatocellular carcinoma with contrast-enhanced ultrasound

doi:10.3760/cma.j.cn371439-20220419-00081

Abstract

Abstract:

Hepatocellular carcinoma （HCC） is a highly prevalent tumor in China. It has an insidious onset, rapid progression, early recurrence and poor prognosis. Most patients are already in the middle and late stages when they are diagnosed and lose the best time for surgery. Therefore, early diagnosis and treatment of HCC is crucial for patients. In recent years, contrast-enhanced ultrasound （CEUS） technology has been widely used in the diagnosis of liver diseases, especially in the diagnosis and treatment of HCC, which has an irreplaceable role. Meanwhile, the image fusion technology developed on the basis of CEUS can highlight the value of CEUS in the diagnosis and treatment of HCC.

Key words: Ultrasonography, Carcinoma, hepatocellular, Image fusion technology

Gao Junrong, Cao Manqing, Deng Yinghong. Advances in the diagnosis and treatment of hepatocellular carcinoma with contrast-enhanced ultrasound[J]. Journal of International Oncology, 2022, 49(7): 425-429.

References 41

[1]	Zhou M, Wang H, Zeng X, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017[J]. Lancet, 2019, 394(10204): 1145-1158. DOI: 10.1016/S0140-6736(19)30427-1. doi: 10.1016/S0140-6736(19)30427-1
[2]	Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2018, 68(6): 394-424. DOI: 10.3322/caac.21492. doi: 10.3322/caac.21492
[3]	国家卫生健康委办公厅. 原发性肝癌诊疗指南(2022年版)[J]. 临床肝胆病杂志, 2022, 38(2): 288-303. DOI: 10.3969/j.issn.1001-5256.2022.02.009. doi: 10.3969/j.issn.1001-5256.2022.02.009
[4]	Eisenbrey JR, Gabriel H, Savsani E, et al. Contrast-enhanced ultrasound (CEUS) in HCC diagnosis and assessment of tumor response to locoregional therapies[J]. Abdom Radio(NY), 2021, 46(8): 3579-3595. DOI: 10.1007/s00261-021-03059-y. doi: 10.1007/s00261-021-03059-y
[5]	Huang JY, Li JW, Lu Q, et al. Diagnostic accuracy of CEUS LI-RADS for the characterization of liver nodules 20 mm or smaller in patients at risk for hepatocellular carcinoma[J]. Radiology, 2020, 294(2): 329-339. DOI: 10.1148/radiol.2019191086. doi: 10.1148/radiol.2019191086
[6]	Park J, Lee JM, Kim TH, et al. Imaging diagnosis of HCC: future directions with special emphasis on hepatobiliary MRI and contrast-enhanced ultrasound[J]. Clin Mol Hepatol, 2022, 28(3): 362-379. DOI: 10.3350/cmh.2021.0361. doi: 10.3350/cmh.2021.0361
[7]	Huang L, Zhou K, Zhang J, et al. Efficacy and safety of high-intensity focused ultrasound ablation for hepatocellular carcinoma by changing the acoustic environment: microbubble contrast agent (SonoVue) and transcatheter arterial chemoembolization[J]. Int J Hyperthermia, 2019, 36(1): 244-252. DOI: 10.1080/02656736.2018.1558290. doi: 10.1080/02656736.2018.1558290
[8]	Beyer LP, Wassermann F, Pregler B, et al. Characterization of focal liver lesions using CEUS and MRI with liver-specific contrast media: experience of a single radiologic center[J]. Ultraschall Med, 2017, 38(6): 619-625. DOI: 10.1055/s-0043-105264. doi: 10.1055/s-0043-105264
[9]	Tai CJ, Huang MT, Wu CH, et al. Contrast-enhanced ultrasound and computed tomography assessment of hepatocellular carcinoma after transcatheter arterial chemo-embolization:a systematic review[J]. J Gastrointestinal Liver Dis, 2016, 25 (4): 499-507. DOI: 10.15403/jgld.2014.1121.254.tai. doi: 10.15403/jgld.2014.1121.254.tai
[10]	Zhang J, Yu Y, Li Y, et al. Diagnostic value of contrast-enhanced ultrasound in hepatocellular carcinoma: a meta-analysis with evidence from 1998 to 2016[J]. Oncotarget, 2017, 8(43): 75418-75426. DOI: 10.18632/oncotarget.20049. doi: 10.18632/oncotarget.20049
[11]	Moudgil S, Kalra N, Prabhakar N, et al. Comparison of contrast enhanced ultrasound with contrast enhanced computed tomography for the diagnosis of hepatocellular carcinoma[J]. J Clin Exp Hepatol, 2017, 7(3):222-229. DOI: 10.1016/j.jceh.2017.03.003. doi: 10.1016/j.jceh.2017.03.003
[12]	Schwarze V, Marschner C, Völckers W, et al. The diagnostic performance of contrast-enhanced ultrasound (CEUS) for evaluating hepatocellular carcinoma (HCC) juxtaposed to MRI findings; a retrospective single-center analysis of 292 patients[J]. Clin Hemorheol Microciric, 2020, 76(2):155-160. DOI: 10.3233/CH-209213. doi: 10.3233/CH-209213
[13]	Hsiao CY, Chen PD, Huang KW. A prospective assessment of the diagnostic value of contrast-enhanced ultrasound, dynamic computed tomography and magnetic resonance imaging for patients with small liver tumors[J]. J Clin Med, 2019, 8(9): 1353-1360. DOI: 10.3390/jcm8091353. doi: 10.3390/jcm8091353
[14]	黄艳丽, 吕校平, 张炽敏. 肝硬化背景下超声造影对肝内微小结节的诊断价值[J]. 医学研究生学报, 2017, 30(3): 298-301. DOI: 10.16571/j.cnki.1008-8199.2017.03.016. doi: 10.16571/j.cnki.1008-8199.2017.03.016
[15]	Chen Y, Zhu Y, Chen K, et al. Differentiation between hepatocellular carcinoma and intrahepatic cholangiocarcinoma using contrast-enhanced ultrasound: a systematic review and meta-analysis[J]. Clin Hemorheol Microcirc, 2021, 79(2): 293-309. DOI: 10.3233/CH-211145. doi: 10.3233/CH-211145
[16]	陈凯玲, 韩红, 毛枫, 等. 初发性与复发性肝细胞癌超声造影增强模式的对比研究[J]. 中国超声医学杂志, 2020, 36(12): 1087-1092. DOI: 10.3969/j.issn.1002-0101.2020.12.008. doi: 10.3969/j.issn.1002-0101.2020.12.008
[17]	Durot I, Wilson SR, Willmann JK. Contrast-enhanced ultrasound of malignant liver lesions[J]. Abdom Radiol (NY), 2018, 43(4): 819-847. DOI: 10.1007/s00261-017-1360-8. doi: 10.1007/s00261-017-1360-8
[18]	Park HJ, Choi BI, Lee ES, et al. How to differentiate borderline hepatic nodules in hepatocarcinogenesis: emphasis on imaging diagnosis[J]. Liver Cancer, 2017, 6(3):189-203. DOI: 10.1159/000455949. doi: 10.1159/000455949
[19]	Lekht I, Nayyar M, Luu B, et al. Intra-arterial contrast-enhanced ultrasound (IA CEUS) for localization of hepatocellular carcinoma (HCC) supply during transarterial chemoembolization (TACE): a case series[J]. Abdominal Radiol (NY), 2017, 42(5): 1400-1407. DOI: 10.1007/s00261-016-1016-0. doi: 10.1007/s00261-016-1016-0
[20]	刘元锋, 余晓梅, 戴旭辉, 等. 超声造影对不同分化程度肝硬化合并小肝癌的诊断价值[J]. 中国超声医学杂志, 2021, 37(6): 659-662. DOI: 10.3969/j.issn.002-0101.2021.06.018. doi: 10.3969/j.issn.002-0101.2021.06.018
[21]	He Y, Liu F, Mou S, et al. Prognostic analysis of hepatocellular carcinoma on the background of liver cirrhosis via contrast-enhanced ultrasound and pathology[J]. Oncol Lett, 2018, 15(3): 3746-3752. DOI: 10.3892/ol.2018.7792. doi: 10.3892/ol.2018.7792
[22]	Erstad DJ, Tanabe KK. Prognostic and therapeutic implications of microvascular invasion in hepatocellular carcinoma[J]. Ann Surg Oncol, 2019, 26(5): 1474-1493. DOI: 10.1245/s10434-019-07227-9. doi: 10.1245/s10434-019-07227-9 pmid: 30788629
[23]	Tu H, Chen L, Lin J, et al. Liver cancer confirmation by contrast-enhanced ultrasound coupled with magnetic resonance imaging: case report of liver inflammation misdiagnosed as atypical liver cancer[J]. J Ultrasound Med, 2020, 39(7): 1453-1457. DOI: 10.1002/jum.15233. doi: 10.1002/jum.15233
[24]	Xu EJ, Lv SM, Li K, et al. Immediate evaluation and guidance of liver cancer thermal ablation by three-dimensional ultrasound/contrast-enhanced ultrasound fusion imaging[J]. Int J Hyperthermia, 2018, 34(6): 870-876. DOI: 10.1080/02656736.2017.1373306. doi: 10.1080/02656736.2017.1373306
[25]	汪玲, 陆英慧, 王天佑. 原发性肝癌患者超声造影定量灌注参数与分化程度及微血管密度的关系[J]. 郑州大学学报(医学版), 2020, 55(5): 681-685. DOI: 10.13705/j.issn.1671-6825.2019.09.109. doi: 10.13705/j.issn.1671-6825.2019.09.109
[26]	汪贤臣, 李世岩, 方勇, 等. 实时三维超声造影在肝癌射频消融术前病灶形态学评估中的应用价值[J]. 中华肿瘤杂志, 2018, 40(3): 217-221. DOI: 10.3760/cma.j.issn.0253-3766.2018.03.012. doi: 10.3760/cma.j.issn.0253-3766.2018.03.012
[27]	Huang DY, Yusuf GT, Daneshi M, et al. Contrast-enhanced US-guided interventions: improving success rate and avoiding complications using US contrast agents[J]. Radiographics, 2017, 37(2): 652-664. DOI: 10.1148/rg.2017160123. doi: 10.1148/rg.2017160123 pmid: 27860550
[28]	Han X, Dong J, Liu Z, et al. Quantitative dynamic contrast-enhanced ultrasound to predict intrahepatic recurrence of hepatocellular carcinoma after radiofrequency ablation: a cohort study[J]. Int J Hyperthermia, 2020, 37(1): 1066-1073. DOI: 10.1080/02656736.2020.1817576. doi: 10.1080/02656736.2020.1817576
[29]	Hai Y, Savsani E, Chong W, et al. Meta-analysis and systematic review of contrast-enhanced ultrasound in evaluating the treatment response after locoregional therapy of hepatocellular carcinoma[J]. Abdom Radio (NY), 2021, 46(11): 5162-5179. DOI: 10.1007/s00261-021-03248-9. doi: 10.1007/s00261-021-03248-9
[30]	张瑶, 贾哲, 何楠, 等. 超声造影辅助超声引导射频消融术治疗原发性肝癌疗效分析[J]. 中国超声医学杂志, 2021, 37(8): 892-896. DOI: 10.3969/j.issn.1002-0101.2021.08.017. doi: 10.3969/j.issn.1002-0101.2021.08.017
[31]	Liu Z, Wang X, Xing L, et al. The application comparison of contrast-enhanced ultrasound and contrast-enhanced computed tomography in radiofrequency ablation treatment for hepatocellular carcinoma[J]. Cancer Biother Radiopharm, 2019, 34(10): 621-625. DOI: 10.1089/cbr.2019.2845. doi: 10.1089/cbr.2019.2845
[32]	何雁, 李蕾, 李小晶, 等. 超声造影时间-强度曲线在肝癌射频消融的应用研究[J]. 重庆医学, 2017, 46(26): 3649-3650, 3654. DOI: 10.3969/j.issn.1671-8348.2017.26.017. doi: 10.3969/j.issn.1671-8348.2017.26.017
[33]	Cao J, Dong Y, Fan P, et al. Early evaluation of treatment response to transarterial chemoembolization in patients with advanced hepatocellular carcinoma: the role of dynamic three-dimensional con-trast-enhanced ultrasound[J]. Clin Hemorheol Microcirc, 2021, 78(4): 365-377. DOI: 10.3233/CH-201086. doi: 10.3233/CH-201086
[34]	Watanabe Y, Ogawa M, Kumagawa M, et al. Utility of contrast-enhanced ultrasound for early therapeutic evaluation of hepatocellular carcinoma after transcatheter arterial chemoembolization[J]. J Ultrasound Med, 2020, 39(3): 431-440. DOI: 10.1002/jum.15118. doi: 10.1002/jum.15118
[35]	Schwarze V, Rübenthaler J, Marschner C, et al. Advanced fusion imaging and contrast-enhanced imaging (CT/MRI-CEUS) in onco-logy[J]. Cancers (Basel), 2020, 12(10): 2821. DOI: 10.3390/cancers12102821. doi: 10.3390/cancers12102821
[36]	European Society of Radiology (ESR). Abdominal applications of ultrasound fusion imaging technique: liver, kidney, and pancreas[J]. Insights Imaging, 2019, 10(1): 6-11. DOI: 10.1186/s13244-019-0692-z. doi: 10.1186/s13244-019-0692-z
[37]	Minami Y, Minami T, Hagiwara S, et al. Ultrasound-ultrasound image overlay fusion improves real-time control of radiofrequency ablation margin in the treatment of hepatocellular carcinoma[J]. Eur Radiol, 2018, 28(5): 1986-1993. DOI: 10.1007/s00330-017-5162-8. doi: 10.1007/s00330-017-5162-8
[38]	Minami Y, Kudo M. Image guidance in ablation for hepatocellular carcinoma: contrast-enhanced ultrasound and fusion imaging[J]. Front Oncol, 2021, 11: 593636. DOI: 10.3389/fonc.2021.593636. doi: 10.3389/fonc.2021.593636
[39]	Lee MW, Lim HK, Rhim H, et al. Percutaneous radiofrequency ablation of small (1-2 cm) hepatocellular carcinomas inconspi-cuous on B-mode ultrasonographic imaging: usefulness of combined fusion imaging with MRI and contrast-enhanced ultrasonography[J]. Can J Gastroenterol Hepatol, 2018, 2018: 7926923. DOI: 10.1155/2018/7926923-7926931. doi: 10.1155/2018/7926923-7926931
[40]	Ju JX, Zeng QJ, Xu EJ, et al. Intraprocedural contrast-enhanced ultrasound-CT/MR fusion imaging assessment in HCC thermal ablation to reduce local tumor progression: compared with routine contrast-enhanced ultrasound[J]. Int J Hyperthermia, 2019, 36(1): 785-793. DOI: 10.1080/02656736.2019.1640899. doi: 10.1080/02656736.2019.1640899
[41]	Ding J, Wang D, Zhou Y, et al. A novel mono-modality fusion imaging method based on three-dimensional contrast-enhanced ultrasound for the evaluation of ablation margins after microwave ablation of hepatocellular carcinoma[J]. J Gastrointest Oncol, 2021, 12(1): 184-195. DOI: 10.21037/jgo-21-46. doi: 10.21037/jgo-21-46