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Updated: Mar 23, 2026
Treatment of Liver Metastases Using an Internal Target Volume Method for Stereotactic Body Radiotherapy
Published on: May 8, 2018
Local Tumor Progression After Hepatocellular Carcinoma Ablation: CEUS LI-RADS Nonradiation TRA Version 2024 Versus a
Jia-Qian Yao1, Huan-Ling Guo1, Xiao-Er Zhang1
1Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Objective:
To assess the performance of CEUS LI-RADS TRA v2024 in differentiating local tumor progression (LTP) and postprocedural inflammation of ablated hepatocellular carcinoma (HCC), and compare it with a modified version.
Methods:
This retrospective study composed HCC patients who underwent CEUS after thermal ablation from June 2010 to June 2023 in our center. Each image of LTP and postprocedural inflammation was reviewed for CEUS LI-RADS TRA v2024 categorization. A modified CEUS LI-RADS TRA emphasizing intralesional washout in defining intralesional tumor viable was established. The diagnostic performance in distinguishing LTP and postprocedural inflammation of the two algorithms was compared.
Results:
Among 2745 HCC patients who underwent 5612 procedures, 212 CEUS observations with 71 postprocedural inflammation (62 males and 9 females, 60.5 ± 11.5 years) and 141 LTPs (125 males and 16 females, 58.8 ± 11.5 years) were enrolled. Interreader agreement for the CEUS LI-RADS TRA category was good (κ = 0.75 [95% CI: 0.69, 0.81]). According to algorithm, 170 (80%) treated lesions were labeled as LR-TR viable and 42 (20%) were assigned as LR-TR equivocal. Emphasizing washout in intralesional viable, the modified LR-TR viable showed significantly greater specificity (58% vs 46%, p = 0.008), AUC (0.77 vs 0.70, p < 0.001) and accuracy (81% vs 78%, p = 0.04) without compromising sensitivity (93% vs 94%, p = 1.00) compared with the original LR-TR viable.
Conclusion:
CEUS LI-RADS TRA performed well in detecting LTP in ablated HCC. The modified algorithm emphasizing intralesional washout in LR-TR viable significantly improved specificity without compromising sensitivity.
