Microvascular flow imaging of residual or recurrent hepatocellular carcinoma after transarterial chemoembolization: Comparison with color/power doppler imaging

Hyo Jin Kang, Jeong Min Lee, Sun Kyung Jeon, Hwaseong Ryu, Jeongin Yoo, Jae Keun Lee, Joon Koo Han

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Objective: To determine the feasibility of microvascular flow imaging (MVFI) in comparison with color/power Doppler imaging (CDI/PDI) for detection of intratumoral vascularity in suspected post-transarterial chemoembolization (TACE) residual or recurrent hepatocellular carcinomas (HCCs) by using contrast-enhanced ultrasonography (CEUS) or hepatic angiography (HA) findings as the reference standard. Materials and Methods: One hundred HCCs (mean size, 2.2 cm) in 100 patients treated with TACE were included in this prospective study. CDI, PDI, and MVFI were performed in tandem for evaluating intratumoral vascularity of the lesions by using an RS85 ultrasound scanner (Samsung Medison Co., Ltd.). Intratumoral vascularity in each technique was assessed by two radiologists in consensus by using a 5-point scale. Then, one of the two radiologists and another radiologist performed additional image review in the reverse order (MVFI-PDI-CDI) for evaluation of intra-and interobserver agreements. Results were then compared with those of either HA or CEUS as the reference. The McNemar test, logistic regression analysis, and intraclass correlation coefficient (ICC) were used. Results: CEUS or HA revealed intratumoral vascularity in 87% (87/100) of the tumors. Sensitivity (79.3%, 69/87) and accuracy (80.0%, 80/100) of MVFI were significantly higher than those of CDI (sensitivity, 27.6% [24/87]; accuracy, 37.0% [37/100]) or PDI (sensitivity, 36.8% [32/87]; accuracy, 44.0% [44/100]) (all p < 0.05). CDI, PDI, and MVFI presented excellent intraobserver (ICCs > 0.9) and good interobserver agreements (ICCs > 0.6). Conclusion: MVFI demonstrated significantly higher sensitivity and accuracy than did CDI and PDI for the detection of intratumoral vascularity in suspected residual or recurrent HCCs after TACE.

Original languageEnglish
Pages (from-to)1114-1123
Number of pages10
JournalKorean Journal of Radiology
Volume20
Issue number7
DOIs
StatePublished - Jul 2019

Keywords

  • Blood flow
  • Doppler imaging
  • Hepatocellular carcinoma
  • Microvascular flow imaging
  • Transarterial chemoembolization

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