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Abdominal Radiology
Published in: Abdominal Radiology 11/2021

01-11-2021 | Ultrasound | Hepatobiliary

Meta-analysis and systematic review of contrast-enhanced ultrasound in evaluating the treatment response after locoregional therapy of hepatocellular carcinoma

Authors: Yang Hai, MD, Esika Savsani, BS, Weelic Chong, BA, John Eisenbrey, PhD, FAIUM, Andrej Lyshchik, MD, PhD, FAIUM, FSRU

Published in: Abdominal Radiology | Issue 11/2021

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Abstract

Purpose

Contrast-enhanced ultrasound (CEUS) is a useful tool to assess treatment response after percutaneous ablation or transarterial chemoembolization (TACE) of hepatocellular carcinoma (HCC). Here, we performed a systematic review and meta-analysis to evaluate the usefulness of CEUS in identifying residual tumor after locoregional therapy.

Methods

PubMed, Scopus, and Cochrane library databases were searched from their inception until March 8, 2021, for diagnostic test accuracy studies comparing CEUS to a reference standard for identifying residual tumors after locoregional therapy of HCC. The pooled sensitivity, specificity, accuracy, and diagnostic odds ratio (DOR) were obtained using a bivariate random effects model. Subgroup analyses were performed by stratifying the studies based on study design, type of locoregional therapy, CEUS criteria for residual tumor, timing of CEUS follow up, and type of standard reference.

Results

Two reviewers independently evaluated 1479 publications. After full-text review, 142 studies were found to be relevant, and 43 publications (50 cohorts) were finally included. The overall sensitivity of CEUS in detection of residual disease estimated from the bivariate random effects model was 0.85 (95% CI 0.80–0.89). Similarly, the overall specificity was 0.94 (95% CI 0.91–0.96). The diagnostic accuracy was 93.5%. The DOR was 70.1 (95% CI 62.2–148), and the AUROC was 0.95. Importantly, subgroup analysis showed no apparent differences in the diagnostic performance between locoregional therapy (TACE vs. ablation) and criteria used to define residual enhancement, timing of performing CEUS, study design, or type of reference standard.

Conclusion

CEUS is a highly accurate method to identify HCC residual tumor after TACE or percutaneous ablation.
Appendix
Available only for authorised users
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Metadata
Title
Meta-analysis and systematic review of contrast-enhanced ultrasound in evaluating the treatment response after locoregional therapy of hepatocellular carcinoma
Authors
Yang Hai, MD
Esika Savsani, BS
Weelic Chong, BA
John Eisenbrey, PhD, FAIUM
Andrej Lyshchik, MD, PhD, FAIUM, FSRU
Publication date
01-11-2021
Publisher
Springer US
Published in
Abdominal Radiology / Issue 11/2021
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-021-03248-9

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WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

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