Mag Intro

Mag Intro Mag Intro

Responsible Institution:
Fudan University
Sponsored by:
Fudan University Shanghai Cancer Center
Edited by:
Editorial Board of Oncoradiology
Editors-in-Chief:
CHANG Cai
PENG Weijun
FAN Wei
Editorial Director: NI Ming
Published by:
Editorial Office of Oncoradiology
Address:
270 Dong’an Road, Shanghai 200032, China
Tel: (021)64188274
Website: www.zhongliuyingxiangxue.com
E-mail：
zlyxx@zhongliuyingxiangxue.com
ISSN 2096-6210　
CN 31-2087/R

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Volume 35 期 1，2026 2026年第35卷第1期

  • Specialists' Commentary

    QIU Yijie, DONG Yi

    DOI：10.19732/j.cnki.2096-6210.2026.01.001
    摘要：Liver cancer is one of the leading causes of cancer-related mortality worldwide. Non-surgical treatments, such as transcatheter arterial chemoembolization (TACE), local ablation therapy, and systemic therapy, serve as crucial therapeutic options for patients with advanced liver cancer. Accurate and early assessment of treatment response following these interventions is essential for timely adjustment and optimization of clinical management strategies. Contrast-enhanced ultrasound (CEUS), with its unique advantages of real-time imaging, non-radiation, and high sensitivity in depicting intratumoral microvascular perfusion, has emerged as a significant imaging modality for efficacy evaluation. This article reviewed the value and recent advances of CEUS-related techniques in assessing the treatment response of liver cancer to non-surgical therapies.  
    关键词：Liver cancer;Contrast-enhanced ultrasound;Non-surgical treatment;Treatment response   
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  • Specialists' Article

    ZHENG Ruiying, ZHANG Yi, LIU Ming, ZHANG Xiaoer, LIU Baoxian, XIE Xiaoyan, HUANG Guangliang

    DOI：10.19732/j.cnki.2096-6210.2026.01.002
    摘要：ObjectiveImmune checkpoint inhibitors and angiogenesis inhibitors combined with locoregional therapies is gradually becoming the first-line treatment for intermediate and advanced hepatocellular carcinoma (HCC). However, target-immunotherapy still has some shortcomings, such as a relatively low effective rate of treatment. Accurately screening patients who may benefit from treatment remains a challenge. This study intends to explore the predictive role of quantitative parameters of contrast-enhanced ultrasound (CEUS) on the tumor response in patients with intermediate and advanced HCC treated with immune checkpoint inhibitors and angiogenesis inhibitors (VEGF inhibitors) combined with locoregional therapies.MethodsHCC patients treated with immune checkpoint inhibitors and VEGF inhibitors combined with locoregional therapies (transarterial chemoembolization or hepatic arterial infusion chemotherapy) were prospectively enrolled. Baseline CEUS examination was performed before treatment, and the tumor perfusion quantitative parameters were analyzed using perfusion quantification software. Tumor response and progression-free survival (PFS) were assessed in these patients. All patients were divided into the response group and the non-response group. The differences in quantitative parameters of CEUS between the two groups were compared, and the correlation between the CEUS parameters and PFS was evaluated.ResultsThe objective response rate of the 66 enrolled patients was 21.2%. The ratios of perfusion parameters between the target lesion and the background liver tissue, such as the rising time ratio, time to peak ratio, fall time ratio, peak enhancement ratio, wash-in rate ratio, wash-in perfusion index ratio, and wash-out rate ratio, showed significant differences between the response group and the non-response group (all P values were <0.05). Only the rising time ratio was an independent factor affecting the objective response rate (P=0.010). The median rising time ratio of the response group and the non-response group were 36.9 and 58.9, respectively (P=0.006). The optimal cutoff value of the rising time ratio was determined to be 80.1 through the X-tile program. Survival analysis showed that patients with a low rising time ratio had a longer PFS (high rising time ratio vs low rising time ratio was 4.4 months vs 19.1 months, P=0.044).ConclusionThe quantitative parameters of CEUS before treatment may have certain value in early predicting the efficacy of immune checkpoint inhibitors and VEGF inhibitors-based combination therapies for HCC.  
    关键词：Hepatocellular carcinoma;Targeted and immunotherapy therapy;Contrast-enhanced ultrasound;Immune checkpoint inhibitor;Angiogenesis inhibitor;Tumor response   
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    CHEN Yanni, YUAN Kai, WANG Feihang, CHEN Keke, ZUO Dan, LIU Guanghua, KONG Wentao, WANG Wenping

    DOI：10.19732/j.cnki.2096-6210.2026.01.003
    摘要：ObjectiveTo analyze the imaging characteristics of hepatocellular carcinoma (HCC) lesions following targeted and immunotherapy, and to explore the diagnostic value of conventional ultrasound and contrast-enhanced ultrasound (CEUS).MethodsA retrospective analysis was conducted on conventional ultrasound and CEUS images from HCC patients who received only targeted and immunotherapy between May 2021 and June 2025 in Zhongshan Hospital, Fudan University. Lesion size, echogenicity, color Doppler flow imaging (CDFI) findings, CEUS phase-specific manifestations (arterial, portal, delayed), and enhancement patterns were observed and recorded.ResultsUsing pathological findings as the diagnostic reference standard, 41 lesions from 25 patients were included. Conventional ultrasound detected 27 lesions, with a detection rate of 65.85% (27/41). Among the total lesions, 78.04% (32/41) were hyperechoic or isoechoic. CDFI detected blood flow in 9 lesions and showed no flow in 18 lesions. After contrast injection, CEUS detected 39 lesions, with a detection rate of 95.12% (39/41). In the arterial phase, 84.61%（33/39）lesions showed entirety enhancement earlier than the liver parenchyma. In the portal phase, 12 lesions showed iso-enhancement, and in the delayed phase, 9 lesions remained iso-enhancement. The proportions of lesions showing iso-enhancement in the portal and delayed phases were 34.29% (12/35) and 25.71% (9/35), respectively, demonstrating "slow wash-out" or "no wash-out" patterns. In this case series, CEUS achieved a diagnostic accuracy of 100.00% (39/39) and a 100.00% (39/39) accuracy in determining the status of residual blood supply in the lesions.ConclusionCEUS is an effective imaging modality for diagnosing and assessing tumor viability in primary hepatocellular carcinoma following targeted and immunotherapy.  
    关键词：Hepatocellular carcinoma;Ultrasound examination;Contrast-enhanced ultrasound;Targeted therapy;Immunotherapy   
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    ZHAO Lin, ZHOU Yan, CHEN Xi, DING Jianmin, JING Xiang

    DOI：10.19732/j.cnki.2096-6210.2026.01.004
    摘要：ObjectiveTo explore the clinical application value of three-dimensional contrast-enhanced ultrasound (3D-CEUS) in evaluating the shape and size of microwave ablation (MWA) lesions of hepatocellular carcinoma (HCC).MethodsHCC patients who underwent ultrasound-guided single-point subpercutaneous MWA with complete ablation at Department of Ultrasound, Tianjin Third Central Hospital/Central Hospital between January 1, 2024, and August 31, 2025. A comparison was conducted between 3D-CEUS and contrast-enhanced computed tomography (CECT) to evaluate the correlation and consistency of these two examination methods in assessing indicators such as the longest diameter, shortest diameter, volume, and true roundness of MWA lesions.ResultsA total of 32 patients and 32 ablation lesions were included. Significant correlations (P<0.001) were observed between 3D-CEUS and CECT in evaluating the indicators of MWA ablation zones in HCC patients, the Pearson correlation coefficients of the long diameter, short diameter 1, and true circularity rate were 0.96, 0.93, and 0.89 respectively. The Spearman correlation coefficients of the volume and short diameter 2 were 0.92 and 0.90 respectively. The consistency of the data of the ablation lesions evaluated by the two examination methods was good (P<0.001). Among them, the volume, long diameter, and short diameter 2 had the best consistency, and the intraclass correlation coefficients (ICC) were 0.95, 0.93, and 0.92 respectively. The short diameter 1 and true circularity rate were second, with ICC of approximately 0.88 and 0.89 respectively.Conclusion3D-CEUS demonstrates significant clinical utility in assessing the morphology, shape, and size of MWA lesions in patients with HCC, and may serve as a reliable imaging modality for post-ablation evaluation in clinical practice.  
    关键词：Hepatocellular carcinoma;Three-dimensional contrast-enhanced ultrasound;Microwave ablation;Ablation lesion shape;Preoperative planning   
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