Qian JJ, Xu M, Ji YS. Assessing predictive value of contrast-enhanced ultrasound combined with doppler ultrasound for post-transcatheter arterial chemoembolization prognosis in hepatocellular carcinoma. World J Gastrointest Surg 2026; 18(1): 114692 [DOI: 10.4240/wjgs.v18.i1.114692]
Corresponding Author of This Article
Min Xu, Associate Chief Physician, Department of Medical Imaging, The Affiliated Huai’an Hospital of Xuzhou Medical University, No. 62 Huaihai South Road, Huai’an 223002, Jiangsu Province, China. xuminxum@163.com
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Oncology
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Retrospective Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jan 27, 2026 (publication date) through Jan 28, 2026
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World Journal of Gastrointestinal Surgery
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1948-9366
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Qian JJ, Xu M, Ji YS. Assessing predictive value of contrast-enhanced ultrasound combined with doppler ultrasound for post-transcatheter arterial chemoembolization prognosis in hepatocellular carcinoma. World J Gastrointest Surg 2026; 18(1): 114692 [DOI: 10.4240/wjgs.v18.i1.114692]
World J Gastrointest Surg. Jan 27, 2026; 18(1): 114692 Published online Jan 27, 2026. doi: 10.4240/wjgs.v18.i1.114692
Assessing predictive value of contrast-enhanced ultrasound combined with doppler ultrasound for post-transcatheter arterial chemoembolization prognosis in hepatocellular carcinoma
Jia-Jiao Qian, Min Xu, Yan-Song Ji
Jia-Jiao Qian, Department of Ultrasound, The Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an 223002, Jiangsu Province, China
Min Xu, Department of Medical Imaging, The Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an 223002, Jiangsu Province, China
Yan-Song Ji, Health Management Center, The Affiliated Huai’an First People’s Hospital of Nanjing Medical University, Huai’an 223300, Jiangsu Province, China
Author contributions: Qian JJ performed most of the experiments and wrote the manuscript; Xu M designed the study and corrected the manuscript; Ji YS was involved in the analytical tools and participated in the collection of human material; all of the authors read and approved the final version of the manuscript to be published.
Institutional review board statement: This study was approved by the Affiliated Huai’an Hospital of Xuzhou Medical University, approval No. HEYLL202582.
Informed consent statement: All patients provided informed consent.
Conflict-of-interest statement: No benefits in any form have been received or will be received from any commercial party directly or indirectly related to the subject of this study.
Data sharing statement: The technical appendix, statistical code, and dataset are available from the corresponding author.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Min Xu, Associate Chief Physician, Department of Medical Imaging, The Affiliated Huai’an Hospital of Xuzhou Medical University, No. 62 Huaihai South Road, Huai’an 223002, Jiangsu Province, China. xuminxum@163.com
Received: October 10, 2025 Revised: November 7, 2025 Accepted: November 28, 2025 Published online: January 27, 2026 Processing time: 103 Days and 1.5 Hours
Abstract
BACKGROUND
Hepatocellular carcinoma (HCC) is a significant global health issue that is often diagnosed in advanced stages. Transcatheter arterial chemoembolization (TACE) is a standard intervention for unresectable HCC; however, it is frequently followed by tumor recurrence, highlighting the need for reliable prognostic tools. This study evaluated the combined predictive value of contrast-enhanced ultrasound (CEUS) and Doppler ultrasound in assessing the clinical outcomes post-TACE.
AIM
To develop a comprehensive imaging strategy that can guide personalized treatment planning through an improved assessment of tumor vascularization and liver function, assess the predictive value of CEUS combined with Doppler ultrasound in patients with HCC who underwent TACE.
METHODS
This retrospective study analyzed 124 patients with HCC who underwent TACE. Based on 1-year outcomes, the patients were stratified into good (n = 86) and poor (n = 38) prognostic groups. We compared the clinical and ultrasound data (CEUS and Doppler parameters) between the groups to identify prognostic factors. Multivariate logistic regression was used to identify independent predictors, and receiver operating characteristic curve was used to evaluate the predictive power of the combined model for post-TACE prognosis.
RESULTS
Significant differences were observed between the two groups in terms of TNM stage, number of lesions, tumor size, arrival time (AT), washout time (WT), hepatic artery peak systolic velocity (VPs), portal vein velocity, and blood flow grading (P < 0.05). Logistic regression analysis showed that TNM stage, tumor size, number of lesions, hepatic artery VPs, and blood flow grading were risk factors affecting the prognosis of patients with HCC following TACE, whereas AT, WT, and portal vein velocity were protective factors (P < 0.05). Receiver operating characteristic curve analysis demonstrated that the area under the curve values for predicting post-TACE prognosis in patients with HCC were as follows: (1) 0.704 for AT; (2) 0.762 for WT; (3) 0.796 for hepatic artery VPs; (4) 0.796 for portal vein velocity; (5) 0.657 for blood flow grading; and (6) 0.942 for the combined model.
CONCLUSION
The combination of CEUS and Doppler ultrasound parameters, which reflect tumor vascularization and liver function, has high a predictive value for the prognosis of patients with HCC following TACE.
Core Tip: This study demonstrated the prognostic efficacy of combining contrast-enhanced ultrasound with Doppler ultrasound to predict postoperative outcomes in patients with hepatocellular carcinoma following transcatheter arterial chemoembolization (TACE). Patients with a favorable prognosis exhibited longer arterial transit and washout times, increased portal vein flow velocity, reduced peak systolic velocity in the hepatic artery, and lower blood flow grading than those with poor outcomes. The combination of these metrics demonstrates significant value in predicting prognosis following TACE in patients with hepatocellular carcinoma and support individualized post-TACE management.
