Yang Hai1, Esika Savsani1, Weelic Chong2,3, John Eisenbrey1, Andrej Lyshchik4. 1. Department of Radiology, Thomas Jefferson University, 132 South 10th Street, 763G Main Building, Philadelphia, PA, 19107, USA. 2. Sidney Kimmel Medical College, Thomas Jefferson University, 1025 Walnut St, Suite 100, Philadelphia, PA, USA. 3. Department of Medical Oncology, Thomas Jefferson University, 1025 Walnut St, Suite 727, Philadelphia, PA, USA. 4. Department of Radiology, Thomas Jefferson University, 132 South 10th Street, 763G Main Building, Philadelphia, PA, 19107, USA. andrej.lyshchik@jefferson.edu.
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.
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.
Authors: Farhad Islami; Kimberly D Miller; Rebecca L Siegel; Stacey A Fedewa; Elizabeth M Ward; Ahmedin Jemal Journal: CA Cancer J Clin Date: 2017-06-06 Impact factor: 508.702
Authors: Jason T Heckman; Michael B Devera; J Wallis Marsh; Paulo Fontes; Nikhil B Amesur; Shane E Holloway; Michael Nalesnik; David A Geller; Jennifer L Steel; T Clark Gamblin Journal: Ann Surg Oncol Date: 2008-08-12 Impact factor: 5.344
Authors: John R Eisenbrey; Flemming Forsberg; Corinne E Wessner; Lauren J Delaney; Kristen Bradigan; Sriharsha Gummadi; Mohamed Tantawi; Andrej Lyshchik; Patrick O'Kane; Ji-Bin Liu; Charles Intenzo; Jesse Civan; Warren Maley; Scott W Keith; Kevin Anton; Allison Tan; Amanda Smolock; Susan Shamimi-Noori; Colette M Shaw Journal: Radiology Date: 2020-12-15 Impact factor: 11.105