Clinical value of contrast-enhanced CT in evaluating treatment response after microwave coagulation for liver cancer<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />

冯蕾　王旸　梁萍　董宝玮　于小玲　于德江　肖秋金

解放军总医院超声科

Abstract

Purpose：To analyze the clinical value of contrast-enhanced helical CT in evaluating treatment response after percutaneous microwave coagulation for liver cancer. 

Materials and methods：From May 1994 to December 2002, 182 patients with 182 tumors (174 hepatocellular carcinomas and 8 metastases) treated with percutaneous microwave coagulation underwent CT imaging at 1 month after treatment. CT findings were interpreted separately by two reviewers with consensus. Clinical follow-up period was no less than 6 months, and the results are regarded as golden standard. The sensitivity, specificity, positive and negative predictive CT values were accessed. Its clinical value in judging treatment response was estimated by checking consistency between contrast-enhanced helical CT and clinical follow-up. Consistency was determined by using Kappa checking. Positive rate was compared by using McNemar c2 test.

Results：After a mean follow-up of 40.68 months, 38 nodules showed residual tumors and 144 nodules showed complete necrosis. At 1 month, the sensitivity, specificity, positive and negative predictive CT values were 57.89%, 99.31%, 95.65% and 89.94% respectively, and the crude agreement and Kappa value were 90.66% and 0.67 respectively. There are significant differences between contrast-enhanced CT and clinical follow-up.

Conclusions：Contrast-enhanced CT was useful for evaluating treatment response after percutaneous microwave coagulation for liver cancer. Taking account of significant differences between contrast-enhanced CT and clinical follow-up, CT should be routinely performed after treatment and the serum tumor markers should also be considered in judging the treatment response. Under some circumstances US-guided biopsy should also be performed.

Keywords：Microwave; Liver carcinoma; CT; sensitivity