在一项多中心前瞻性研究中，比较 3D 超声造影 (CEUS)/MRI-CEUS 融合成像与 2D-CEUS 在评估肝细胞癌 (HCC) 对局部治疗的反应方面的诊断准确性。连续一系列 HCC 患者纳入2021年4月至2023年3月期间计划进行局部治疗的患者。患者被随机分为3D-CEUS/MRI-CEUS融合成像组（3D/融合组）或2D-CEUS组（2D组）。局部治疗前 1 周和治疗后 4-6 周进行 CEUS。以治疗后4-6周的增强磁共振成像（CE-MRI）作为参考标准。评估 CEUS 图像是否存在活肿瘤。确定每种方式的诊断性能标准，包括敏感性、特异性、准确性和曲线下面积 (AUC)。 总共纳入 140 名患者，其中 2D 组 70 名患者（平均年龄 60.2±10.4 岁）， 3D/融合组有 70 名患者（平均年龄，59.8±10.6 岁）。 3D/融合组的敏感性为100.0%（95% CI: 75.9, 100.0），高于2D组（55.6%, 95% CI: 22.7, 84.7；p = 0.019）。 3D/融合组的特异性为96.3% (95% CI: 86.2, 99.4)，与2D组相当(98.4%, 95% CI: 90.0, 99.9; p = 0.915)。 3D/融合组的AUC为0.98（95% CI：0.95，1.00），高于2D组（0.77，95% CI：0.56，0.98；p = 0.020）。3D-CEUS/MRI-CEUS融合成像在评估 HCC 局部治疗的反应方面表现出卓越的诊断准确性。3D-CEUS/MRI-CEUS 融合成像可应用于接受局部治疗的 HCC 残余肿瘤的治疗后评估，在准确度方面提供潜在的好处诊断和临床管理。评估局部治疗后的 HCC 复发非常重要。 3D-CEUS/MRI-CEUS 融合成像在评估局部治疗后残留肿瘤方面比 2D-CEUS 具有更高的灵敏度。 3D-CEUS/MRI-CEUS 融合成像可以帮助临床医生对局部治疗后残留的 HCC 病灶进行早期干预。© 2024。作者获得欧洲放射学会的独家许可。

To compare the diagnostic accuracy of 3D contrast-enhanced ultrasound (CEUS)/MRI-CEUS fusion imaging with 2D-CEUS in assessing the response of hepatocellular carcinoma (HCC) to locoregional therapies in a multicenter prospective study.A consecutive series of patients with HCC scheduled for locoregional treatment were enrolled between April 2021 and March 2023. Patients were randomly divided into 3D-CEUS/MRI-CEUS fusion imaging group (3D/fusion group) or 2D-CEUS group (2D group). CEUS was performed 1 week before and 4-6 weeks after locoregional treatment. Contrast-enhanced MRI (CE-MRI) 4-6 weeks after treatment was set as the reference standard. CEUS images were evaluated for the presence or absence of viable tumors. Diagnostic performance criteria, including sensitivity, specificity, accuracy, and area under the curve (AUC), were determined for each modality.A total of 140 patients were included, 70 patients in the 2D group (mean age, 60.2 ± 10.4 years) and 70 patients in the 3D/fusion group (mean age, 59.8 ± 10.6 years). The sensitivity of the 3D/fusion group was 100.0% (95% CI: 75.9, 100.0), higher than that of the 2D group (55.6%, 95% CI: 22.7, 84.7; p = 0.019). The specificity of the 3D/fusion group was 96.3% (95% CI: 86.2, 99.4), which was comparable to that of the 2D group (98.4%, 95% CI: 90.0, 99.9; p = 0.915). The AUC of the 3D/fusion group was 0.98 (95% CI: 0.95, 1.00), higher than that of the 2D group (0.77, 95% CI: 0.56, 0.98; p = 0.020).3D-CEUS/MRI-CEUS fusion imaging exhibits superior diagnostic accuracy in evaluating the treatment response to locoregional therapies for HCC.3D-CEUS/MRI-CEUS fusion imaging can be applied for post-treatment assessment of residual tumors in HCC undergoing locoregional treatment, offering potential benefits in terms of accurate diagnosis and clinical management.Evaluating for HCC recurrence following locoregional therapy is important. 3D-CEUS/MRI-CEUS fusion imaging achieved a higher sensitivity than 2D-CEUS in assessing residual tumors after locoregional therapies. 3D-CEUS/MRI-CEUS fusion imaging can help clinicians intervene early in residual HCC lesions after locoregional treatment.© 2024. The Author(s), under exclusive licence to European Society of Radiology.