ArticleEuropean radiology2024
3D fusion is superior to 2D point-to-point contrast-enhanced US to evaluate the ablative margin after RFA for hepatocellular carcinoma.
Article in European radiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 11 citations in OpenAlex.
- The local efficacy and influencing factors of ultrasound-guided percutaneous radiofrequency ablation in sub-cardiac hepatic tumor: A 7-year experience at a single center.Abdominal radiology (New York) · 2026Article
- The role of liver stiffness measurement in predicting Long-term liver function after partial hepatectomy.Abdominal radiology (New York) · 2026Article
- Current advancements and future directions in contrast-enhanced ultrasound (CEUS) in liver oncology: from quantification to theranostics.Polish journal of radiology · 2026Review
- Review
- Intelligent automatic registration: is it feasible and efficient for application of ultrasound fusion imaging in liver?Abdominal radiology (New York) · 2025Article
- Quantitative Ablation Confirmation Methods in Percutaneous Thermal Ablation of Malignant Liver Tumors: Technical Insights, Clinical Evidence, and Future Outlook.Radiology. Imaging cancer · 2025Review
- The value of contrast-enhanced ultrasound fusion imaging in percutaneous liver biopsy for liver lesions invisible on conventional B-mode ultrasound.Quantitative imaging in medicine and surgery · 2025Article
- Development and validation of a prognostic nomogram for early hepatocellular carcinoma treated with microwave ablation.Frontiers in oncology · 2025Article
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Authors and funding
8 authors at 5 institutions in 1 country.
Funding
Abstract
purposeTo compare the efficiency of three-dimensional (3D) and two-dimensional (2D) contrast-enhanced ultrasound (CEUS)-derived techniques in evaluating the ablative margin (AM) after radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC).
methodsIn total, 98 patients with 98 HCCs were enrolled. The 2D CEUS point-to-point imaging (2D CEUS-PI) was conducted by comparing the pre- and post-RFA 2D CEUS images manually, and the 3D CEUS fusion imaging (3D CEUS-FI) was conducted by fusing the pre- and post-RFA 3D CEUS images automatically. These two techniques were compared in distinguishing an adequate AM ≥ 5 mm. Risk factors for local tumor progression (LTP) after RFA were analyzed by the Kaplan-Meier method with log-rank test.
resultsThe mean registration time of 3D CEUS-FI and 2D CEUS-PI was 5.0 and 9.3 min, respectively (p < 0.0001). The kappa coefficient was 0.680 for agreement between 2D CEUS-PI and 3D CEUS-FI in the evaluation of AM (p < 0.0001). Tumors with AM < 5 mm by 2D CEUS-PI were all identified as AM < 5 mm by 3D CEUS-FI. Nonetheless, 16 (26%) tumors identified as AM ≥ 5 mm by 2D CEUS-PI were re-classified as AM < 5 mm by 3D CEUS-FI. During a median follow-up time of 31.2 months (range, 3.2-66.0 months), LTP was identified in 8 tumors. The estimated 1-/2-/3-year cumulative incidence of LTP was 4.4%, 8.1%, and 10.3%, respectively. Higher estimated cumulative incidence of LTP was identified in tumors with AM < 5 mm by 2D CEUS-PI (at 3-year, 27.2% vs 0%; p < 0.001), and by 3D CEUS-FI (at 3-year, 20.7% vs 0%; p = 0.004).
conclusion3D CEUS-FI excelled in the evaluation of AM when compared with 2D CEUS-PI. With equivalent efficacy in the prediction of LTP, 3D CEUS-FI was superior to 2D CEUS-PI for its automatic and time-saving procedure. CLINICAL RELEVANCE STATEMENT: 3D CEUS fusion imaging may serve as an effective tool in evaluating ablative margin and predicting local tumor progression after RFA in HCC. KEY POINTS: • Both 2D and 3D CEUS-derived techniques could evaluate ablative margin (AM) after RFA for hepatocellular carcinoma. • 3D CEUS fusion imaging was more precise in the evaluation of AM compared to 2D CEUS point-to-point imaging, with advantages of its automatic and time-saving procedure. • An inadequate AM < 5 mm evaluated by CEUS-derived techniques was the only risk factor of LTP after RFA for hepatocellular carcinoma (p < 0.001 for 2D CEUS point-to-point imaging, and p = 0.004 for 3D CEUS fusion imaging).
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