Quantitative perfusion analysis of contrast-enhanced ultrasound for the preoperative prediction of microvascular invasion: an experimental study in rabbit VX2 liver tumors.
4 affiliations
- 1Department of Interventional Ultrasound, First Hospital of Shanxi Medical University, Taiyuan, China.
- 2Department of Medical Imaging, Shanxi Medical University, Taiyuan, China.
- 3Department of Ultrasound, The Fifth Clinical Medical College of Shanxi Medical University, Taiyuan, China.
- 4Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China.
Abstract
Microvascular invasion (MVI) is a critical risk factor for postoperative recurrence and metastasis in hepatocellular carcinoma (HCC); however, reliable noninvasive preoperative prediction remains challenging. This study aimed to investigate the value of contrast-enhanced ultrasound (CEUS) in evaluating MVI in rabbit VX2 liver tumors. Twenty healthy New Zealand rabbits were selected and used to establish VX2 liver tumor models. After 2 weeks, all models underwent conventional ultrasonography and CEUS with SonoVue (Bracco). We plotted time-intensity curves (TICs) to derive quantitative parameters, including mean intensity of the TIC (mTIC), peak intensity (PI), arrival time (AT), rise time (RT), time to peak (TTP), flow-out time (FT), and mean transit time (mTT). Based on histological diagnosis, tumors were classified into MVI and non-MVI groups. We compared the two groups in terms of the differences between VX2 tumors and the surrounding hepatic parenchyma. (I) Histological examination confirmed that 39 VX2 liver tumor models were successfully established in rabbits, with a tumor inoculation success rate of 97.50%. Among these, MVI was identified in 21 VX2 tumors. (II) Compared to tumors in the non-MVI group, those in the MVI group exhibited a larger diameter (P=0.01). Quantitative CEUS analysis revealed that the MVI group, compared to a non-MVI group, had a higher mTIC and PI (P=0.02 and P<0.001, respectively) and a shorter AT and TTP (both P values =0.03). (III) The RT of VX2 tumors was shorter than that of the surrounding liver parenchyma in both the MVI and non-MVI groups (P=0.002 and P=0.047, respectively). In the MVI group, the AT and TTP of the tumors were shorter (P=0.049 and P<0.001, respectively) while the PI was higher compared to the adjacent parenchyma (P=0.01). (IV) Receiver operating characteristic analysis showed that the PI achieved the highest diagnostic performance, with an area under the curve of 0.79 [95% confidence interval (CI): 0.65-0.93]. Quantitative CEUS parameters provide crucial information for evaluating MVI in VX2 liver tumors. These findings constitute experimental evidence that supports the clinical assessment of tumor aggressiveness.
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BibTeX
@article{zhang2026quantitative,
title = {{Quantitative perfusion analysis of contrast-enhanced ultrasound for the preoperative prediction of microvascular invasion: an experimental study in rabbit VX2 liver tumors.}},
author = {Qian Zhang and Zhilong Liu and Qin Lu and Yanjing Zhang and Yufang Zhao and Ping Liang and Liping Liu},
journal = {Quantitative imaging in medicine and surgery},
year = {2026},
month = sep,
doi = {10.21037/qims-2026-1318},
url = {https://europepmc.org/article/MED/42997938},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Quantitative perfusion analysis of contrast-enhanced ultrasound for the preoperative prediction of microvascular invasion: an experimental study in rabbit VX2 liver tumors.
AU - Qian Zhang
AU - Zhilong Liu
AU - Qin Lu
AU - Yanjing Zhang
AU - Yufang Zhao
AU - Ping Liang
AU - Liping Liu
PY - 2026
DA - 2026/09/29
JO - Quantitative imaging in medicine and surgery
DO - 10.21037/qims-2026-1318
UR - https://europepmc.org/article/MED/42997938
AB - Microvascular invasion (MVI) is a critical risk factor for postoperative recurrence and metastasis in hepatocellular carcinoma (HCC); however, reliable noninvasive preoperative prediction remains challenging. This study aimed to investigate the value of contrast-enhanced ultrasound (CEUS) in evaluating MVI in rabbit VX2 liver tumors. Twenty healthy New Zealand rabbits were selected and used to establish VX2 liver tumor models. After 2 weeks, all models underwent conventional ultrasonography and CEUS with SonoVue (Bracco). We plotted time-intensity curves (TICs) to derive quantitative parameters, including mean intensity of the TIC (mTIC), peak intensity (PI), arrival time (AT), rise time (RT), time to peak (TTP), flow-out time (FT), and mean transit time (mTT). Based on histological diagnosis, tumors were classified into MVI and non-MVI groups. We compared the two groups in terms of the differences between VX2 tumors and the surrounding hepatic parenchyma. (I) Histological examination confirmed that 39 VX2 liver tumor models were successfully established in rabbits, with a tumor inoculation success rate of 97.50%. Among these, MVI was identified in 21 VX2 tumors. (II) Compared to tumors in the non-MVI group, those in the MVI group exhibited a larger diameter (P=0.01). Quantitative CEUS analysis revealed that the MVI group, compared to a non-MVI group, had a higher mTIC and PI (P=0.02 and P<0.001, respectively) and a shorter AT and TTP (both P values =0.03). (III) The RT of VX2 tumors was shorter than that of the surrounding liver parenchyma in both the MVI and non-MVI groups (P=0.002 and P=0.047, respectively). In the MVI group, the AT and TTP of the tumors were shorter (P=0.049 and P<0.001, respectively) while the PI was higher compared to the adjacent parenchyma (P=0.01). (IV) Receiver operating characteristic analysis showed that the PI achieved the highest diagnostic performance, with an area under the curve of 0.79 [95% confidence interval (CI): 0.65-0.93]. Quantitative CEUS parameters provide crucial information for evaluating MVI in VX2 liver tumors. These findings constitute experimental evidence that supports the clinical assessment of tumor aggressiveness.
SN - 2223-4292
SN - 2223-4306
ER -