Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Surgical Endoscopy
Published in: Surgical Endoscopy 4/2018

01-04-2018

Diagnostic accuracy of contrast-enhanced ultrasound in assessing the therapeutic response to radio frequency ablation for liver tumors: systematic review and meta-analysis

Authors: Min Xuan, Fengsheng Zhou, Yan Ding, Qiaoying Zhu, Ji Dong, Hao Zhou, Jun Cheng, Xiao Jiang, Pengxi Wu

Published in: Surgical Endoscopy | Issue 4/2018

Login to get access

Abstract

Background

To review the diagnostic accuracy of contrast-enhanced ultrasound (CEUS) used to detect residual or recurrent liver tumors after radiofrequency ablation (RFA). This technique uses contrast-enhanced computer tomography or/and contrast-enhanced magnetic resonance imaging as the gold standard of investigation.

Methods

MEDLINE, EMBASE, and COCHRANE were systematically searched for all potentially eligible studies comparing CEUS with the reference standard that follows RFA. Risk of bias and applicability concerns were addressed by adopting the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Pooled point estimates for sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratios (DOR) with 95% CI were computed before plotting the sROC (summary receiver operating characteristic) curve. Meta-regression and subgroup analysis were used to identify the source of the heterogeneity that was detected. Publication bias was evaluated using Deeks’ funnel plot asymmetry test.

Results

Ten eligible studies on 1162 lesions that occurred between 2001 and 2016 were included in the final analysis. The quality of the included studies assessed by the QUADAS-2 tool was considered reasonable. The pooled sensitivity and specificity of CEUS in detecting residual or recurrent liver tumors had the following values: 0.90 (95% CI 0.85–0.94) and 1.00 (95% CI 0.99–1.00), respectively. Overall DOR was 420.10 (95% CI 142.30–1240.20). The sources of heterogeneity could not be precisely identified by meta-regression or subgroup analysis. No evidence of publication bias was found.

Conclusion

This study confirmed that CEUS exhibits high sensitivity and specificity in assessing therapeutic responses to RFA for liver tumors.
Literature
1.
Usatoff V, Habib N (2000) Hepatic malignancy: challenges and opportunities for the surgeon. J R Coll Surg Edinb 45 99–109PubMed
2.
Ahmed M, Solbiati L, Brace CL et al (2014) Image-guided tumor ablation: standardization of terminology and reporting criteria—a 10-year update. J Vasc Interv Radiol 25:1691–1705CrossRefPubMed
3.
Mcgahan JP, Browning PD, Brock JM, Tesluk H (1990) Hepatic ablation using radiofrequency electrocautery. Invest Radiol 25:267–270CrossRefPubMed
4.
Wood TF, Rose DM, Chung M, Allegra DP, Foshag LJ, Bilchik AJ (2000) Radiofrequency ablation of 231 unresectable hepatic tumors: indications, limitations, and complications. Ann Surg Oncol 7:593–600CrossRefPubMed
5.
Shiina S, Tateishi R, Arano T et al (2012) Radiofrequency ablation for hepatocellular carcinoma: 10-year outcome and prognostic factors. Am J Gastroenterol 107:569–577CrossRefPubMed
6.
Pulvirenti A, Garbagnati F, Regalia E et al (2001) Experience with radiofrequency ablation of small hepatocellular carcinomas before liver transplantation. Transplant Proc 33:1516-1517CrossRef
7.
Crocetti L, De Baere T, Lencioni R (2010) Quality improvement guidelines for radiofrequency ablation of liver tumours. Cardiovasc Intervent Radiol 33:11–17CrossRefPubMed
8.
Albrecht T, Blomley M, Bolondi L et al (2004) Guidelines for the use of contrast agents in ultrasound. Ultraschall Med 25:249–256CrossRefPubMed
9.
Kitajima K, Maeda T, Watanabe S, Sugimura K (2011) Recent issues in contrast-induced nephropathy. Int J Urol 18:686–690CrossRefPubMed
10.
Vilana R, Bianchi L, Varela M et al (2006) Is microbubble-enhanced ultrasonography sufficient for assessment of response to percutaneous treatment in patients with early hepatocellular carcinoma? Eur Radiol 16:2454–2462CrossRefPubMed
11.
Claudon M, Dietrich CF, Choi BI et al (2013) Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS) in the liver–update 2012. Ultraschall Med 34:11–29PubMed
12.
Shiozawa K, Watanabe M, Takayama R et al (2010) Evaluation of local recurrence after treatment for hepatocellular carcinoma by contrast-enhanced ultrasonography using Sonazoid: Comparison with dynamic computed tomography. J Clin Ultrasound 38:182–189PubMed
13.
Shimizu M, Iijima H, Horibe T et al (2004) Usefulness of contrast-enhanced ultrasonography with a new contrast mode, agent detection imaging, in evaluating therapeutic response in hepatocellular carcinoma treated with radio-frequency ablation therapy. Hepatol Res 29:235–242CrossRefPubMed
14.
Numata K, Fukuda H, Morimoto M et al (2012) Use of fusion imaging combining contrast-enhanced ultrasonography with a perflubutane-based contrast agent and contrast-enhanced computed tomography for the evaluation of percutaneous radiofrequency ablation of hypervascular hepatocellular carcinoma. Eur J Radiol 81:2746–2753CrossRefPubMed
15.
Vilana R, Llovet JM, Bianchi L et al (2003) Contrast-enhanced power doppler sonography and helical computed tomography for assessment of vascularity of small hepatocellular carcinomas before and after percutaneous ablation. J Clin Ultrasound 31:119 –128CrossRefPubMed
16.
Luo W, Numata K, Morimoto M et al (2010) Role of Sonazoid-enhanced three-dimensional ultrasonography in the evaluation of percutaneous radiofrequency ablation of hepatocellular carcinoma. Eur J Radiol 75:91–97CrossRefPubMed
17.
Glas AS, Lijmer JG, Prins MH, Bonsel GJ, Bossuyt PM (2003) The diagnostic odds ratio: a single indicator of test performance. J Clin Epidemiol 56:1129–1135CrossRefPubMed
18.
Bruce N, Pope D, Stanistreet D (2008) Quantitative methods for health research: a practical interactive guide to epidemiology and statistics. Wiley, ChichesterCrossRef
19.
Whiting PF, Rutjes AW, Westwood ME et al (2011) QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med 155:529–536CrossRefPubMed
20.
Deeks JJ, Macaskill P, Irwig L (2005) The performance of tests of publication bias and other sample size effects in systematic reviews of diagnostic test accuracy was assessed. J Clin Epidemiol 58:882–893CrossRefPubMed
21.
Salvaggio G, Campisi A, Lo Greco V, Cannella I, Meloni MF, Caruso G (2010) Evaluation of posttreatment response of hepatocellular carcinoma: Comparison of ultrasonography with second-generation ultrasound contrast agent and multidetector CT. Abdom Imaging 35:447–453CrossRefPubMed
22.
Du J, Li HL, Zhai B, Chang S, Li FH (2015) Radiofrequency ablation for hepatocellular carcinoma: utility of conventional ultrasound and contrast-enhanced ultrasound in guiding and assessing early therapeutic response and short-term follow-up results. Ultrasound Med Biol 41:2400–2411CrossRefPubMed
23.
Wiggermann P, Zuber-Jerger I, Zausig Y et al (2011) Contrast-enhanced ultrasound improves real-time imaging of ablation region during radiofrequency ablation: preliminary results. Clin Hemorheol Microcirc 49:43–54PubMed
24.
Ricci P, Cantisani V, Drudi F et al. (2009) Is contrast-enhanced US alternative to spiral CT in the assessment of treatment outcome of radiofrequency ablation in hepatocellular carcinoma?. Ultraschall Med 30:252–258CrossRefPubMed
25.
Gallotti A, D’Onofrio M, Ruzzenente A et al (2009) Contrast-enhanced ultrasonography (CEUS) immediately after percutaneous ablation of hepatocellular carcinoma. Radiol Med 114:1094–1105CrossRefPubMed
26.
Mauri G, Porazzi E, Cova L et al (2014) Intraprocedural contrast-enhanced ultrasound (CEUS) in liver percutaneous radiofrequency ablation: clinical impact and health technology assessment. Insights Imaging 5:209–216CrossRefPubMedPubMedCentral
27.
Dill-Macky MJ, Asch M, Burns P, Wilson S (2006) Radiofrequency ablation of hepatocellular carcinoma: predicting success using contrast-enhanced sonography. Am J Roentgenol 186:S287-S95CrossRef
28.
Meloni MF, Goldberg SN, Livraghi T et al (2001) Hepatocellular carcinoma treated with radiofrequency ablation: comparison of pulse inversion contrast-enhanced harmonic sonography, contrast-enhanced power Doppler sonography, and helical CT. Am J Roentgenol 177:375–380CrossRef
29.
Wen YL, Kudo M, Zheng RQ et al (2003) Radiofrequency ablation of hepatocellular carcinoma: therapeutic response using contrast-enhanced coded phase-inversion harmonic sonography. Am J Roentgenol 181:57–63CrossRef
30.
Kim CK, Choi D, Lim HK et al (2005) Therapeutic response assessment of percutaneous radiofrequency ablation for hepatocellular carcinoma: utility of contrast-enhanced agent detection imaging. Eur J Radiol 56:66–73CrossRefPubMed
31.
Zintzaras E, Ioannidis J (2005) Heterogeneity testing in meta-analysis of genome searches. Genet Epidemiol 28:123–137CrossRefPubMed
32.
Bipat S, van Leeuwen MS, Comans EF et al. (2005) Colorectal liver metastases: CT, MR imaging, and PET for diagnosis—meta-analysis. Radiology 237:123–131CrossRefPubMed
33.
Hohmann J, Albrecht T, Hoffmann C, Wolf K-J (2003) Ultrasonographic detection of focal liver lesions: increased sensitivity and specificity with microbubble contrast agents. Eur J Radiol 46:147–159CrossRefPubMed
34.
Konopke R, Bunk A, Kersting S (2007) The role of contrast-enhanced ultrasound for focal liver lesion detection: an overview. Ultrasound Med Biol 33:1515–1526CrossRefPubMed
35.
Meuwly J-Y, Schnyder P, Gudinchet F, Denys AL (2003) Pulse-inversion harmonic imaging improves lesion conspicuity during US-guided biopsy. J Vasc Interv Radiol 14:335–341CrossRefPubMed
36.
37.
Yanagisawa K, Moriyasu F, Miyahara T, Yuki M, Iijima H (2007) Phagocytosis of ultrasound contrast agent microbubbles by Kupffer cells. Ultrasound Med Biol 33:318–325CrossRefPubMed
38.
Berry JD, Sidhu PS (2006) Microbubble contrast-enhanced ultrasound features of common focal liver lesions: a guide for the novice. Ultrasound 14:190–201CrossRef
Metadata
Title
Diagnostic accuracy of contrast-enhanced ultrasound in assessing the therapeutic response to radio frequency ablation for liver tumors: systematic review and meta-analysis
Authors
Min Xuan
Fengsheng Zhou
Yan Ding
Qiaoying Zhu
Ji Dong
Hao Zhou
Jun Cheng
Xiao Jiang
Pengxi Wu
Publication date
01-04-2018
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 4/2018
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-017-5903-4

Other articles of this Issue 4/2018

Surgical Endoscopy 4/2018 Go to the issue

OriginalPaper

What are the influencing factors for chronic pain following TAPP inguinal hernia repair: an analysis of 20,004 patients from the Herniamed Registry

OriginalPaper

Effects of cholecystectomy on recurrent biliary complications after endoscopic treatment of common bile duct stone: a population-based cohort study

OriginalPaper

Validation of the VBLaST pattern cutting task: a learning curve study

OriginalPaper

Understanding intestinal glucose transporter expression in obese compared to non-obese subjects

OriginalPaper

Comparison of two new techniques for the management of malignant central airway obstruction: argon plasma coagulation with mechanical tumor resection versus cryorecanalization

OriginalPaper

Bile duct injury and morbidity following cholecystectomy: a need for improvement