Imaging Modalities for Treatment Response in Hepatocellular Carcinoma
Summary
Accurate assessment of treatment response in hepatocellular carcinoma (HCC) is critical for guiding clinical decision-making and optimising patient outcomes. Conventional imaging with computed tomography (CT) and magnetic resonance imaging (MRI) remains the cornerstone for post-therapy surveillance, yet these modalities often lack the temporal resolution to detect early vascular changes. Ultrasound-based techniques, notably contrast-enhanced ultrasound (CEUS) and its dynamic counterpart (DCE-US), provide real-time evaluation of microvascular perfusion, offering insights into tumour viability shortly after locoregional therapies such as radiofrequency ablation or transarterial chemoembolisation. Positron emission tomography–CT (PET-CT), exploiting metabolic tracers, adds another dimension by quantifying functional changes in neoplastic tissue. Emerging hybrid approaches and computational tools, including quantitative parametric mapping and predictive nomograms, integrate multimodal data to refine response prediction. Collectively, these imaging advances promise earlier discrimination between responders and non-responders, enabling timely adaptation of therapeutic strategy and ultimately improving survival rates across diverse clinical settings.
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Imaging Modalities for Treatment Response in Hepatocellular Carcinoma publication trend
The graph below shows the total number of articles in imaging modalities for treatment response in hepatocellular carcinoma across all publications each year (not limited to Nature Index journals).
Technical terms
Contrast-enhanced ultrasound (CEUS): Ultrasonography performed after intravenous injection of microbubble contrast to visualise lesion perfusion in real time.
Dynamic contrast-enhanced ultrasound (DCE-US): Quantitative analysis of CEUS data over time to generate time-intensity curves reflecting microvascular flow.
Positron emission tomography–computed tomography (PET-CT): Hybrid imaging modality that integrates metabolic tracer distribution from PET with anatomical detail from CT.
Nomogram: A graphical calculation tool that combines multiple variables to estimate the probability of a clinical outcome.
Modified Response Evaluation Criteria in Solid Tumours (mRECIST): A set of guidelines focusing on viable tumour enhancement rather than size alone to assess treatment response in HCC.
Time-intensity curve: A plot of contrast signal intensity versus time, used to quantify perfusion kinetics within a region of interest.
References
- A contrast-enhanced ultrasound-based nomogram for the prediction of therapeutic efficiency of anti-PD-1 plus anti-VEGF agents in advanced hepatocellular carcinoma patients. Frontiers in Immunology (2023).
- Dynamic Contrast-Enhanced Ultrasound in the Prediction of Advanced Hepatocellular Carcinoma Response to Systemic and Locoregional Therapies. Cancers (2024).
- 13N-Ammonia PET-CT for Evaluating Response to Antiangiogenic Therapy and Prognosis in Patients with Advanced Hepatocellular Carcinoma: A Pilot Study. Cancers (2025).
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