Comparison of Contrast-Enhanced Ultrasound and CT/MRI in Transarterial Chemoembolization and Hepatic Arterial Infusion Chemotherapy.

[OBJECTIVE] Early assessment of treatment response following locoregional therapy remains a challenge in managing hepatocellular carcinoma (HCC). Recent advancements in contrast-enhanced ultrasound (CEUS) have demonstrated significant potential in the early assessment of tumor viability. This study compared the evaluation capabilities of CEUS and CT/MRI in assessing treatment response to hepatic arterial infusion chemotherapy (HAIC) and transarterial chemoembolization (TACE).

[MATERIALS AND METHODS] This study included patients who had received TACE or HAIC between 2010 and 2024. 1:1 propensity score matching was used to reduce confounding bias between the TACE and HAIC groups. A comparative analysis was carried out using pathological complete response of treated lesions as the reference standard to assess the diagnostic performance of CEUS and CT/MRI across different treatment strategies.

[RESULTS] A total of 154 patients with 167 observations were ultimately included. In the propensity score matching cohort, CEUS and CT/MRI demonstrated similar diagnostic performance, with no significant differences in sensitivity (96% vs 92%, p = 0.07) or specificity (67% vs 57%, p > 0.99). Additionally, CEUS showed comparable results between HAIC and TACE groups in both sensitivity (98% vs 94%, p = 0.61) and specificity (50% vs 77%, p = 0.35).

[CONCLUSION] CEUS demonstrated no significant difference in diagnostic performance compared with CT/MRI in evaluating HCC treatment response to HAIC and TACE.