Yoon Jun Sik, Lee Yu Rim, Kweon Young-Oh, Tak Won Young, Jang Se Young, Park Soo Young, Hur Keun, Park Jung Gil, Lee Hye Won, Chun Jae Min, Han Young Seok, Lee Won Kee
Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital.
Department of Biochemistry and Cell Biology, School of Medicine, Kyungpook National University.
Eur J Gastroenterol Hepatol. 2018 Oct;30(10):1230-1236. doi: 10.1097/MEG.0000000000001170.
To compare the clinical value of acoustic radiation force impulse (ARFI) elastography and transient elastography (TE) for hepatocellular carcinoma (HCC) recurrence prediction after radiofrequency ablation (RFA) and to investigate other predictors of HCC recurrence.
Between 2011 and 2016, 130 patients with HCC who underwent ARFI elastography and TE within 6 months before curative RFA were prospectively enrolled. Independent predictors of HCC recurrence were analyzed separately using ARFI elastography and TE. ARFI elastography and TE accuracy to predict HCC recurrence was determined by receiver operating characteristic curve analysis.
Of all included patients (91 men; mean age, 63.5 years; range: 43-84 years), 51 (42.5%) experienced HCC recurrence during the follow-up period (median, 21.9 months). In multivariable analysis using ARFI velocity, serum albumin and ARFI velocity [hazard ratios: 2.873; 95% confidence interval (CI): 1.806-4.571; P<0.001] were independent predictors of recurrence, and in multivariable analysis using TE value, serum albumin and TE value (hazard ratios: 1.028; 95% CI: 1.013-1.043; P<0.001) were independent predictors of recurrence. The area under the receiver operating characteristic curve of ARFI elastography (0.821; 95% CI: 0.747-0.895) was not statistically different from that of TE (0.793; 95% CI: 0.712-0.874) for predicting HCC recurrence (P=0.827). The optimal ARFI velocity and TE cutoff values were 1.6 m/s and 14 kPa, respectively.
ARFI elastography and TE yield comparable predictors of HCC recurrence after RFA.
比较声学辐射力脉冲（ARFI）弹性成像和瞬时弹性成像（TE）对肝细胞癌（HCC）射频消融（RFA）术后复发预测的临床价值，并探究HCC复发的其他预测因素。
2011年至2016年期间，前瞻性纳入130例在根治性RFA术前6个月内接受ARFI弹性成像和TE检查的HCC患者。分别使用ARFI弹性成像和TE分析HCC复发的独立预测因素。通过受试者工作特征曲线分析确定ARFI弹性成像和TE预测HCC复发的准确性。
在所有纳入患者中（91例男性；平均年龄63.5岁；范围：43 - 84岁），51例（42.5%）在随访期间出现HCC复发（中位数为21.9个月）。在使用ARFI速度的多变量分析中，血清白蛋白和ARFI速度[风险比：2.873；95%置信区间（CI）：1.806 - 4.571；P < 0.001]是复发的独立预测因素，在使用TE值的多变量分析中，血清白蛋白和TE值（风险比：1.028；95% CI：1.013 - 1.043；P < 0.001）是复发的独立预测因素。ARFI弹性成像预测HCC复发的受试者工作特征曲线下面积（0.821；95% CI：0.747 - 0.895）与TE（0.793；95% CI：0.712 - 0.874）相比，差异无统计学意义（P = 0.827）。ARFI速度和TE的最佳截断值分别为1.6 m/s和14 kPa。
ARFI弹性成像和TE对RFA术后HCC复发的预测价值相当。
