Contrast-enhanced ultrasonography used for post-treatment responses evaluation of radiofrequency ablations for hepatocellular carcinoma: a meta-analysis.
OBJECTIVE
This meta-analysis aims to analyze the usefulness of contrast-enhanced ultrasonography (CEUS) for post-treatment responses evaluation of radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) management.


METHODS
Literature retrieval in three databases PubMed, Embase and Cochrane Library was conducted up to September 2015, with pre-defined criteria. The technical success rate, local tumour recurrence and local tumour progression were the measurement indexes. Cochran's Q test and I(2) were used for heterogeneity detection. Subgroup analyses were performed for complete ablation rate stratified by study designs, contrast agents and post-operative testing time points. Statistical analyses were conducted using Stata(®) 12.0 software (Stata Corporation, College Station, TX).


RESULTS
12 studies consisting of 772 patients were included in this study. The CEUS-evaluated success rate of RFA for HCCs was 91%. The proportion of ablative margin <5 mm was 53%. The local tumour recurrence rate and local tumour progression rate were 4% and 8%, respectively. Subgroup analysis indicated that the CEUS-assessed technical success rate with Sonazoid™ (Daiichi-Sankyo, Tokyo, Japan) as the contrast agent was higher (95%) than those with other agents [SH U 508A (Schering AG, Berlin, Germany) 86%; SonoVue (Bracco SpA, Milan, Italy) 87%]. The success rate assessed within 24 h (94%) after treatment was higher than longer time (1-3 days 86%; 1 month 91%).


CONCLUSIONS
The meta-analysis showed that the CEUS-evaluated success rate of RFA for HCCs was 91%. The local tumour recurrence rate and local tumour progression rate were 4% and 8%, respectively.


CONCLUSIONS
Using meta-analysis, the study provided more reliable assessment of usefulness of CEUS, which could provide guidelines for HCC treatment.
1 Department of Radiology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China.
Weixiang
W
Shi
2 Department of Ultrasound, Tumor Hospital of Nantong University, Nantong, Jiangsu, China.
Ying
Y
He
1 Department of Radiology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China.
Wenbin
W
Ding
1 Department of Radiology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China.
Shenchu
S
Gong
3 Department of Oncology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China.
Yilang
Y
Wang
4 Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong, Jiangsu, China.
Jing
J
Xiao
1 Department of Radiology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China.
Bosheng
B
He
D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000601:surgery*; D017115:Catheter Ablation; D003287:Contrast Media; D018450:Disease Progression; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D009364:Neoplasm Recurrence, Local; D014463:Ultrasonography
D003287:Contrast Media