Cerrito Lucia, Ainora Maria Elena, Cuccia Giuseppe, Galasso Linda, Mignini Irene, Esposto Giorgio, Garcovich Matteo, Riccardi Laura, Gasbarrini Antonio, Zocco Maria Assunta
Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy.
CEMAD Digestive Disease Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy.
Cancers (Basel). 2024 Jan 27;16(3):551. doi: 10.3390/cancers16030551.
Hepatocellular carcinoma (HCC) is the most frequent primary liver cancer and the sixth most common malignant tumor in the world, with an incidence of 2-8% per year in patients with hepatic cirrhosis or chronic hepatitis. Despite surveillance schedules, it is sometimes diagnosed at an advanced stage, requiring complex therapeutic efforts with both locoregional and systemic treatments. Traditional radiological tools (computed tomography and magnetic resonance) are used for the post-treatment follow-up of HCC. The first follow-up imaging is performed at 4 weeks after resection or locoregional treatments, or after 3 months from the beginning of systemic therapies, and subsequently every 3 months for the first 2 years. For this reason, these radiological methods do not grant the possibility of an early distinction between good and poor therapeutic response. Contrast-enhanced ultrasound (CEUS) and dynamic contrast-enhanced ultrasound (DCE-US) have gained the interest of several researchers for their potential role in the early assessment of response to locoregional treatments (chemoembolization) or antiangiogenic therapies in patients with advanced HCC. In fact, DCE-US, through a quantitative analysis performed by specific software, allows the construction of time-intensity curves, providing an evaluation of the parameters related to neoplastic tissue perfusion and its potential changes following therapies. It has the invaluable advantage of being easily repeatable, minimally invasive, and able to grant important evaluations regarding patients' survival, essential for well-timed therapeutic changes in case of unsatisfying response, and eventual further treatment planning.
肝细胞癌（HCC）是最常见的原发性肝癌，也是全球第六大常见恶性肿瘤，在肝硬化或慢性肝炎患者中的年发病率为2%-8%。尽管有监测计划，但有时仍在晚期才被诊断出来，这需要进行包括局部和全身治疗在内的复杂治疗。传统的放射学工具（计算机断层扫描和磁共振成像）用于HCC治疗后的随访。首次随访成像在切除或局部治疗后4周进行，或在全身治疗开始3个月后进行，随后在最初2年内每3个月进行一次。因此，这些放射学方法无法早期区分治疗反应的好坏。超声造影（CEUS）和动态对比增强超声（DCE-US）因其在晚期HCC患者局部治疗（化疗栓塞）或抗血管生成治疗反应早期评估中的潜在作用而受到了几位研究人员的关注。事实上，DCE-US通过特定软件进行的定量分析，可以构建时间-强度曲线，对与肿瘤组织灌注相关的参数及其治疗后的潜在变化进行评估。它具有易于重复、微创的宝贵优势，并且能够对患者的生存情况进行重要评估，这对于在反应不满意时及时进行治疗调整以及最终的进一步治疗规划至关重要。
