Observational Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Aug 15, 2025; 17(8): 105818
Published online Aug 15, 2025. doi: 10.4251/wjgo.v17.i8.105818
Contrast-enhanced ultrasound in evaluating the curative effect of interventional therapy in patients with liver cancer
Li-Ping Chen, Yan Dong, Jing-Guang He, Qing-Qing Yang, Zhi-Wen Hu
Li-Ping Chen, Yan Dong, Jing-Guang He, Zhi-Wen Hu, Department of Medical Ultrasound, Guangzhou First People's Hospital, Guangzhou 510180, Guangdong Province, China
Qing-Qing Yang, Department of Medical Ultrasound, The Second People’s Hospital of Baiyun, Guangzhou 510450, Guangdong Province, China
Co-first authors: Li-Ping Chen and Yan Dong.
Author contributions: Chen LP drafted the initial draft; Chen LP and Dong Y drafted the initial draft, contributed to the formal analysis as the co-first authors of the paper; Chen LP and Hu ZW participated in data collection and the concept of study, guided the research, methodology, and visualization of the manuscript; Dong Y, He JG and Yang QQ contributed to the formal analysis of this study; Chen LP, Dong Y, He JG, Yang QQ, and Hu ZW participated in this study, validated it, and jointly reviewed and edited the manuscript; all of the authors read and approved the final version of the manuscript to be published.
Supported by Science and Technology Program of Guangzhou, No. 2024A03J1029; Science and Technology Program of Chinese Medicine and Integrated Chinese and Western Medicine in Guangzhou, No. 20252A010001.
Institutional review board statement: This research has been reviewed and approved by the Ethics Committee of Guangzhou First People's Hospital.
Informed consent statement: The informed consent forms signed by the patients were obtained in this study.
Conflict-of-interest statement: The authors of this study declare that there is no conflict of interest.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement: No available data.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhi-Wen Hu, MD, Department of Medical Ultrasound, Guangzhou First People's Hospital, No. 1 Panfu Road, Guangzhou 510180, Guangdong Province, China. charleyhu@163.com
Received: April 25, 2025
Revised: May 29, 2025
Accepted: July 1, 2025
Published online: August 15, 2025
Processing time: 110 Days and 17.4 Hours
Abstract
BACKGROUND

Contrast-enhanced ultrasonography (CEUS) is utilized to assess the therapeutic efficacy of interventional therapy in liver cancer patients, offering insights into tumor blood flow changes, angiogenesis, and tumor markers.

AIM

To evaluate the use of CEUS in examining the effectiveness of interventional therapy for liver cancer, we aim to investigate its diagnostic utility for tumor perfusion patterns, microvessel density, perfusion recovery, blood flow enhancement response, and alterations in tumor markers among patients receiving interventional therapy for liver cancer.

METHODS

The study involved 124 patients who underwent interventional therapy for liver cancer at Guangzhou First People’s Hospital from January 2022 to February 2024. All patients were examined using CEUS before treatment and at 1 month, 3 months, and 6 months, and the concentrations of tumor markers were collected and statistically analyzed using Statistical Package for the Social Sciences 25.0. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficacy of CEUS and analyze its sensitivity, specificity, and correlation with clinical indicators.

RESULTS

Before treatment, tumor blood flow was primarily enhanced. After treatment, enhanced perfusion declined, while uniform and non-uniform perfusion increased, indicating reduced tumor activity. Enhanced perfusion decreased from 68.25% before treatment to 53.75% at 6 months post-treatment (F = 6.123, P = 0.016), indicating reduced tumor activity. The microvessel density of the tumors decreased significantly after treatment (P < 0.05), and the proportion of low microvessel density increased. After treatment, perfusion recovery in the tumor area improved, the proportion of complete and partial responses gradually increased, and the proportion of stable lesions decreased (P < 0.05). The levels of alpha-fetoprotein, carcinoembryonic antigen, and carbohydrate antigen 19-9 decreased by 68.7%, 30.4%, and 41.6%, respectively, at 6 months post-treatment (P < 0.05). CEUS showed a sensitivity of 85.72%, specificity of 92.31%, and area under the curve of 0.911 (95%CI: 0.883–0.939) for evaluating treatment response. ROC curve analysis showed that CEUS had high sensitivity and specificity and could effectively evaluate the efficacy of interventional therapy for liver cancer.

CONCLUSION

CEUS has high diagnostic value in evaluating therapeutic effects in patients with liver cancer following interventional therapy. It can reflect changes in tumor blood flow, angiogenesis, and tumor marker levels, providing an effective basis for real-time monitoring of treatment outcomes.

Keywords: Contrast-enhanced ultrasound; Liver cancer; Interventional therapy; Blood perfusion; Tumor microvessel density; Tumor markers; Alpha-fetoprotein; Perfusion recovery; Receiver operating characteristic curve

Core Tip: This observational study highlights the value of contrast-enhanced ultrasonography (CEUS) in evaluating the therapeutic response of liver cancer patients to interventional therapy. CEUS enables real-time visualization of tumor perfusion patterns, microvessel density changes, and alterations in tumor markers. Among 124 patients, CEUS demonstrated high sensitivity (85.72%) and specificity (92.31%) in assessing treatment efficacy. Notably, tumor blood flow and tumor marker levels (alpha-fetoprotein, carcinoembryonic antigen, carbohydrate antigen 19-9) significantly decreased post-treatment. These findings support CEUS as a reliable, noninvasive tool for monitoring treatment outcomes and guiding clinical decision-making in liver cancer management.