ArticleTranslational cancer research2026
Systematic evaluation and meta-analysis of the diagnostic accuracy of ultrasound contrast in predicting the efficacy of systemic therapy for advanced hepatocellular carcinoma.
Article in Translational cancer research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Contrast-enhanced ultrasound (CEUS) is a dynamic, noninvasive imaging modality capable of real-time visualization of tumor perfusion characteristics. This systematic review and meta-analysis quantitatively evaluated the diagnostic efficacy of CEUS in predicting the response to systemic therapy in advanced hepatocellular carcinoma (HCC), aiming to validate its potential clinical value as an imaging biomarker. Methods: Databases including PubMed, Web of Science, Embase, and Cochrane Library were searched up to May 31, 2025. Diagnostic studies using modified Response Evaluation Criteria in Solid Tumors (mRECIST) or Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 as reference standards were included to evaluate CEUS prediction of systemic treatment response. Two researchers independently screened literature and extracted data, assessing methodological quality using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Sensitivity and specificity were pooled using a bivariate random-effects model, and area under the curve (AUC) was calculated via summary receiver operating characteristic (SROC) curve plotting. Results: Five studies involving 114 HCC patients were included. The pooled sensitivity of CEUS for predicting treatment response was 0.88 [95% confidence interval (CI): 0.66-0.96], with a specificity of 0.86 (95% CI: 0.59-0.96). The SROC curve showed that CEUS demonstrated good discriminatory ability with an AUC of 0.92 (95% CI: 0.90-0.94). Spearman correlation analysis revealed no threshold effect (P≥0.05). Sensitivity analysis results were stable, with no single study significantly influencing the overall outcome. Conclusions: CEUS demonstrates promising potential in predicting the efficacy of systemic therapy for advanced HCC and serves as an effective adjunct to computed tomography (CT) or magnetic resonance imaging (MRI) in evaluating treatment response. However, due to the limited number of included studies and sample sizes, further validation of its diagnostic performance and clinical utility through large-scale, multicenter, prospective, high-quality research is still required.
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