Weixiang Shi and Ying He should both be regarded as first authors.Objective: This meta-analysis aims to analyze the usefulness of contrast-enhanced ultrasonography (CEUS) for posttreatment responses evaluation of radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) management. Methods: Literature retrieval in three databases PubMed, Embase and Cochrane Library was conducted up to September 2015, with pre-defined criteria. The technical success rate, local tumour recurrence and local tumour progression were the measurement indexes. Cochran's Q test and I 2 were used for heterogeneity detection. Subgroup analyses were performed for complete ablation rate stratified by study designs, contrast agents and post-operative testing time points. Statistical analyses were conducted using Stata® 12.0 software (Stata Corporation, College Station, TX). Results: 12 studies consisting of 772 patients were included in this study. The CEUS-evaluated success rate of RFA for HCCs was 91%. The proportion of ablative margin ,5 mm was 53%. The local tumour recurrence rate and local tumour progression rate were 4% and 8%, respectively. Subgroup analysis indicated that the CEUS-assessed technical success rate with Sonazoid™ (Daiichi-Sankyo, Tokyo, Japan) as the contrast agent was higher (95%) than those with other agents [SH U 508A (Schering AG, Berlin, Germany) 86%; SonoVue (Bracco SpA, Milan, Italy) 87%]. The success rate assessed within 24 h (94%) after treatment was higher than longer time (1-3 days 86%; 1 month 91%).
Conclusion:The meta-analysis showed that the CEUSevaluated success rate of RFA for HCCs was 91%. The local tumour recurrence rate and local tumour progression rate were 4% and 8%, respectively. Advances in knowledge: Using meta-analysis, the study provided more reliable assessment of usefulness of CEUS, which could provide guidelines for HCC treatment.
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