Quantitative analysis of tumor perfusion via contrast-enhanced ultrasound to predict the neoadjuvant chemotherapy efficacy for children with hepatoblastoma

Background Predicting the neoadjuvant chemotherapy efficacy may help choose appropriate treatment strategy of hepatoblastoma. Quantitative analysis of contrast-enhanced ultrasound (CEUS) has been used to predict the chemotherapy efficacy in various types of tumors, but its value in hepatoblastoma has not been fully evaluated. Objective To explore the value of quantitative analysis of CEUS in predicting the neoadjuvant chemotherapy efficacy for hepatoblastoma. Materials and methods Thirty-five hepatoblastoma patients who require neoadjuvant chemotherapy and underwent liver CEUS in our hospital from January 2017 to July 2023 were enrolled. A CEUS examination was performed at baseline, and perfusion parameters were obtained via perfusion quantification software. Patients were classified into responder group and non-responder group after 2 courses. The differences in quantitative parameters between two groups were compared. Results The MeanLin ratio (1.7 vs. 0.6 and 1.7 vs. 0.8), PE ratio (1.8 vs. 0.9 and 1.9 vs. 0.9), WiAUC ratio (1.3 vs. 0.6 and 1.3 vs. 0.6), WiPI ratio (1.9 vs. 0.8 and 2.0 vs. 0.9), WoAUC ratio (1.3 vs. 0.5 and 1.3 vs. 0.7), and WiWoAUC ratio (1.3 vs. 0.6 and 1.3 vs. 0.7) in the response group were significantly higher than those in the non-response group (all p  < 0.05); when tumor’s region of interest was the active area, the WiR ratio (3.1 vs. 1.4) of the responder group was significantly higher ( p  = 0.04). The proportion of lesions with liquefaction necrosis before chemotherapy was significantly higher in the response group ( p  = 0.049). Conclusion Quantitative analysis of CEUS may have the potential to predict the neoadjuvant chemotherapy efficacy for hepatoblastoma.