Diagnostic performance of contrast-enhanced ultrasonography for predicting therapeutic response to radiofrequency ablation in patients with hepatocellular carcinoma: a meta-analysis

Abstract Purpose Contrast-enhanced ultrasound (CEUS) is frequently used to detect residual or recurrent liver cancer following radiofrequency ablation (RFA) therapy for hepatocellular carcinoma (HCC). However, disagreements persist regarding its diagnostic efficacy. This study aimed to assess the di...

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Main Authors: Ji Dong, Xin Hu, Lin Li, Fei-Yan Jing, Jin-Jin Chen, Jun Chen
Format: Article
Language:English
Published: Springer 2025-07-01
Series:Discover Oncology
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Online Access:https://doi.org/10.1007/s12672-025-03008-x
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author Ji Dong
Xin Hu
Lin Li
Fei-Yan Jing
Jin-Jin Chen
Jun Chen
author_facet Ji Dong
Xin Hu
Lin Li
Fei-Yan Jing
Jin-Jin Chen
Jun Chen
author_sort Ji Dong
collection DOAJ
description Abstract Purpose Contrast-enhanced ultrasound (CEUS) is frequently used to detect residual or recurrent liver cancer following radiofrequency ablation (RFA) therapy for hepatocellular carcinoma (HCC). However, disagreements persist regarding its diagnostic efficacy. This study aimed to assess the diagnostic value of contrast-enhanced ultrasonography (CEUS) for detecting residual or recurrent hepatocellular carcinoma (HCC) after radiofrequency ablation (RFA) using a meta-analytic approach. Methods PubMed, Embase, and the Cochrane Library were searched for studies published up to March 2024. The diagnostic value of CEUS was assessed using sensitivity, specificity, PLR, NLR, diagnostic odds ratio (DOR), and area under the receiver operating characteristic (ROC) curve (AUC). Results This meta-analysis included 13 studies with 802 HCC patients (964 lesions). CEUS demonstrated high sensitivity (0.88, 95% CI: 0.80–0.93) and specificity (0.98, 95% CI: 0.96–0.99) for detecting residual or recurrent tumors after RFA. The positive likelihood ratio (PLR) was 46.88 (95% CI: 20.69–106.24) and the negative likelihood ratio (NLR) was 0.12 (95% CI: 0.07–0.21). The diagnostic odds ratio (DOR) was 222.77 (95% CI: 100.23–495.16), with an AUC of 0.96 (95% CI: 0.94–0.97). Factors such as publication year, study design, ethnicity, blinding, patient age, contrast agent usage, and reference tests were found to influence CEUS’s diagnostic accuracy. Conclusion CEUS exhibited excellent diagnostic performance for detecting residual or recurrent tumors in HCC patients after RFA. Therefore, it should be employed in clinical practice for evaluating therapeutic response to RFA. Registration Number INPLASY202440089.
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spelling doaj-art-adc9f0a7690a4d508dc30bbbdc9af7b52025-08-20T03:45:35ZengSpringerDiscover Oncology2730-60112025-07-0116111710.1007/s12672-025-03008-xDiagnostic performance of contrast-enhanced ultrasonography for predicting therapeutic response to radiofrequency ablation in patients with hepatocellular carcinoma: a meta-analysisJi Dong0Xin Hu1Lin Li2Fei-Yan Jing3Jin-Jin Chen4Jun Chen5Department of Ultrasound Medicine, Affiliated Wuxi Fifth Hospital of Jiangnan University (The Fifth People’s Hospital of Wuxi)Department of Ultrasound Medicine, Affiliated Wuxi Fifth Hospital of Jiangnan University (The Fifth People’s Hospital of Wuxi)Department of Ultrasound Medicine, Affiliated Wuxi Fifth Hospital of Jiangnan University (The Fifth People’s Hospital of Wuxi)Department of Ultrasound Medicine, Affiliated Wuxi Fifth Hospital of Jiangnan University (The Fifth People’s Hospital of Wuxi)Department of Ultrasound Medicine, Affiliated Wuxi Fifth Hospital of Jiangnan University (The Fifth People’s Hospital of Wuxi)Department of Ultrasound Medicine, The Affiliated Wuxi People’s Hospital of Nanjing Medical UniversityAbstract Purpose Contrast-enhanced ultrasound (CEUS) is frequently used to detect residual or recurrent liver cancer following radiofrequency ablation (RFA) therapy for hepatocellular carcinoma (HCC). However, disagreements persist regarding its diagnostic efficacy. This study aimed to assess the diagnostic value of contrast-enhanced ultrasonography (CEUS) for detecting residual or recurrent hepatocellular carcinoma (HCC) after radiofrequency ablation (RFA) using a meta-analytic approach. Methods PubMed, Embase, and the Cochrane Library were searched for studies published up to March 2024. The diagnostic value of CEUS was assessed using sensitivity, specificity, PLR, NLR, diagnostic odds ratio (DOR), and area under the receiver operating characteristic (ROC) curve (AUC). Results This meta-analysis included 13 studies with 802 HCC patients (964 lesions). CEUS demonstrated high sensitivity (0.88, 95% CI: 0.80–0.93) and specificity (0.98, 95% CI: 0.96–0.99) for detecting residual or recurrent tumors after RFA. The positive likelihood ratio (PLR) was 46.88 (95% CI: 20.69–106.24) and the negative likelihood ratio (NLR) was 0.12 (95% CI: 0.07–0.21). The diagnostic odds ratio (DOR) was 222.77 (95% CI: 100.23–495.16), with an AUC of 0.96 (95% CI: 0.94–0.97). Factors such as publication year, study design, ethnicity, blinding, patient age, contrast agent usage, and reference tests were found to influence CEUS’s diagnostic accuracy. Conclusion CEUS exhibited excellent diagnostic performance for detecting residual or recurrent tumors in HCC patients after RFA. Therefore, it should be employed in clinical practice for evaluating therapeutic response to RFA. Registration Number INPLASY202440089.https://doi.org/10.1007/s12672-025-03008-xContrast-enhanced ultrasonographyRadiofrequency ablationHepatocellular carcinomaLikelihood ratioMeta-analysis
spellingShingle Ji Dong
Xin Hu
Lin Li
Fei-Yan Jing
Jin-Jin Chen
Jun Chen
Diagnostic performance of contrast-enhanced ultrasonography for predicting therapeutic response to radiofrequency ablation in patients with hepatocellular carcinoma: a meta-analysis
Discover Oncology
Contrast-enhanced ultrasonography
Radiofrequency ablation
Hepatocellular carcinoma
Likelihood ratio
Meta-analysis
title Diagnostic performance of contrast-enhanced ultrasonography for predicting therapeutic response to radiofrequency ablation in patients with hepatocellular carcinoma: a meta-analysis
title_full Diagnostic performance of contrast-enhanced ultrasonography for predicting therapeutic response to radiofrequency ablation in patients with hepatocellular carcinoma: a meta-analysis
title_fullStr Diagnostic performance of contrast-enhanced ultrasonography for predicting therapeutic response to radiofrequency ablation in patients with hepatocellular carcinoma: a meta-analysis
title_full_unstemmed Diagnostic performance of contrast-enhanced ultrasonography for predicting therapeutic response to radiofrequency ablation in patients with hepatocellular carcinoma: a meta-analysis
title_short Diagnostic performance of contrast-enhanced ultrasonography for predicting therapeutic response to radiofrequency ablation in patients with hepatocellular carcinoma: a meta-analysis
title_sort diagnostic performance of contrast enhanced ultrasonography for predicting therapeutic response to radiofrequency ablation in patients with hepatocellular carcinoma a meta analysis
topic Contrast-enhanced ultrasonography
Radiofrequency ablation
Hepatocellular carcinoma
Likelihood ratio
Meta-analysis
url https://doi.org/10.1007/s12672-025-03008-x
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