Follow-up of Hepatocellular Carcinoma After Transarterial Chemoembolization; The Concordance of Contrast Enhanced Ultrasonography and Lipiodol CT

Background/Aims: The aim of this study is to evaluate the concordance of contrast-enhanced ultrasonography (CEUS) and lipiodol computed tomography (L-CT) for the assessment of viable hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE). Methods:We retrospectively reviewed the post-TACE CEUS and L-CT images of 65 consecutive HCCs in 41 patients to assess the presence of viable tumor tissue.Forty-seven HCCs in 31 patients that underwent post-TACE L-CT within 4 weeks of the CEUS examination were included.The degree of concordance between CEUS and L-CT and factors related to concordance were analyzed.Results: The overall concordance of CEUS and LDCT was 78.7% (37/47).The concordance with L-CT for viable tumor and non-viable tumor tissue on CEUS was 95.2%, and 65.4% respectively (P<0.013).Diffuse tumors had a tendency for non-concordance (P=0.066).Although 3 of 4 lesions located in the hepatic dome were non-concordant, the sample size was too small to establish significance.The mean tumor size for concordant and non-concordant tumors was 2.9 and 3.0 cm, with no significant difference. Conclusions:Although the concordance of CEUS and L-CT for viable tumor tissue was high, the concordance for non-viable tumor tissue was relatively low.Prospective studies using angiography as a gold standard should be performed in the future.(