title: Clinical value of dynamic 3-dimensional contrast-enhanced ultrasound imaging for the assessment of hepatocellular carcinoma ablation.
abstract: OBJECTIVE
  The aim of the study was to investigate the performance of dynamic 3-dimensional contrast-enhanced ultrasound (3D-CEUS) on assessment of efficacy of local ablation therapy of hepatocellular carcinoma (HCC) with contrast-enhanced computed tomography (CT) as reference standard.
  
  
  METHODS
  Eighty-nine HCC lesions from 75 patients undergoing ultrasound-guided percutaneous thermal ablation or chemical ablation were studied by both dynamic 3D-CEUS and contrast-enhanced CT 1month after ablation. Imaging results from two imaging modalities were evaluated independently by experienced readers to determine whether the treated lesions were ablated incompletely (residual unablated tumor) or completely. Sensitivity, specificity, positive and negative predictive values, and accuracy to identify incomplete ablation were calculated for dynamic 3D-CEUS imaging with contrast-enhanced CT as reference standard.
  
  
  RESULTS
  Contrast-enhanced CT reported that 80.9% (72/89) of all the treated lesions were completely ablated and 19.1% (17/89) were incompletely ablated. The dynamic 3D-CEUS identified 82.0% (73/89) and 18.0% (16/89) of lesions as completely and incompletely ablated, respectively. With contrast-enhanced CT as the reference standard, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of dynamic 3D-CEUS for identifying residual unablated tumor were 88.2% (15/17), 98.6% (71/72), 93.8% (15/16), 97.3% (71/73), and 96.6% (86/89), respectively. The Kappa value for identifying residual unablated tumor between contrast-enhanced CT and dynamic 3D-CEUS was 0.89.
  
  
  CONCLUSIONS
  Dynamic 3D-CEUS is highly consistent with contrast-enhanced CT in assessment of efficacy of HCC ablation and has potential to serve as an alternative to contrast-enhanced CT in the follow-up assessment after HCC ablation.
authors.affiliation: Department of Ultrasound, Tianjin Third Central Hospital, Tianjin Key Laboratory of Artificial Cell, Tianjin 300170, China.
authors.forename: Yandong
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Ultrasound, Tianjin Third Central Hospital, Tianjin Key Laboratory of Artificial Cell, Tianjin 300170, China. Electronic address: dr.jingxiang@aliyun.com.
authors.forename: Xiang
authors.initials: X
authors.lastname: Jing
authors.affiliation: Department of Ultrasound, Tianjin Third Central Hospital, Tianjin Key Laboratory of Artificial Cell, Tianjin 300170, China.
authors.forename: Jianmin
authors.initials: J
authors.lastname: Ding
mesh_terms: D055011:Ablation Techniques; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000601:surgery; D003287:Contrast Media; D013505:Digestive System Surgical Procedures; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography / Q000379:methods*
chemical_list: D003287:Contrast Media
keywords: 3-dimensional; Ablation; Contrast agent; Hepatocellular carcinoma; Ultrasound examination