Application of dynamic contrast enhanced ultrasound analysis in predicting early response to systemic therapy of intrahepatic cholangiocarcinoma

Xiu-Yun Lu; Jun Jiang; Sheng Chen; Yi-Jie Qiu; Ying Wang; Juan Cheng; Xin-Liang Xu; Yi Dong; Wen-Ping Wang

doi:10.1016/j.ejrad.2024.111439

Application of dynamic contrast enhanced ultrasound analysis in predicting early response to systemic therapy of intrahepatic cholangiocarcinoma

Eur J Radiol. 2024 Mar 23:175:111439. doi: 10.1016/j.ejrad.2024.111439. Online ahead of print.

Authors

Xiu-Yun Lu¹, Jun Jiang¹, Sheng Chen¹, Yi-Jie Qiu¹, Ying Wang¹, Juan Cheng¹, Xin-Liang Xu¹, Yi Dong¹, Wen-Ping Wang²

Affiliations

¹ Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai JiaoTong University School of Medicine, 200092, Shanghai, China.
² Department of Ultrasound, Zhongshan Hospital, Fudan University, 200032, Shanghai, China.

PMID: 38547743
DOI: 10.1016/j.ejrad.2024.111439

Abstract

Objective: To evaluate the value of dynamic contrast-enhanced ultrasound (DCE-US) analysis in early prediction of tumor response to systemic treatment in patients with intrahepatic cholangiocarcinoma (ICC).

Patients & methods: In this retrospective study, patients diagnosed with ICC by core needle biopsy and histopathological results were included. All patients were diagnosed as advanced stages (stage III/IV) by the 8th edition of the American Joint Committee on Cancer (AJCC)/International Union Against Cancer (UICC) TNM staging system. Liver contrast-enhanced ultrasound (CEUS) examination, DCE-US analysis, CT/MRI, and blood tests were performed in all patients before and 2 months after systemic treatment. CEUS procedure was performed using an ultrasound system (ACUSON Sequoia; Siemens Medical Solutions, Germany) equipped with a 5C1 MHz convex array transducer. Time-intensity curves (TIC) and quantitative parameters were created with VueBox software. According to one-year results of the modified Response Evaluation Criteria in Solid Tumors (m-RECIST) based on CT/MRI, patients were divided into the responder group (RG) and the non-responder group (NRG). Before and 2 months after systemic therapy, the DCE-US perfusion parameters was compared using the paired-sample t test and the Wilcoxon test.

Results: From September 2020 to December 2021, a total of 24 patients diagnosed with advanced ICC were included (11 males, 13 females, mean age 59.4 ± 1.8 years). According to the one year of m-RECIST results, 17 cases (70.8 %) were classified as non-responders by the final m-RECIST criteria, while 7 cases (19.2 %) were responders. Comparing before and 2 months after therapy, the RG took longer time to reach peak intensity, and the peak intensity of TIC was lower. While the TICs of NRG revealed faster enhancement after therapy. Among all DCE-US quantitative parameters, PE (peak enhancement), WiR (wash-in rate), WiPI (wash-in perfusion index) and WoR (wash-out rate) reduced significantly following 2 months of systemic therapy in RG (P < 0.05). Comparing to RG, PE and WiPI decreased slightly 2 months after therapy in NRG (P < 0.05).

Conclusions: The DCE-US analysis with quantitative parameters has the potential value to make early and quantitative evaluation of treatment response to systemic therapy in ICC patients.

Keywords: Dynamic contrast enhanced ultrasound (DCE-US); Quantitative parameters; Therapeutic response; intrahepatic cholangiocarcinoma (ICC); time-intensity curves (TICs).