ORIGINAL RESEARCH article
Front. Oncol.
Sec. Gastrointestinal Cancers: Hepato Pancreatic Biliary Cancers
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1687044
This article is part of the Research TopicLiver Cancer Awareness Month 2024: Current Progress and Future Prospects on Advances in Primary Liver Cancer Investigation and TreatmentView all 24 articles
Combined Imaging and Serum Biomarkers in CEUS-Guided Microwave Ablation for Hepatocellular Carcinoma: A Meta-analysis
Provisionally accepted
- 1Dalian Municipal Friendship Hospital, Dalian, China
- 2the second hospital of dalian medical university, Daliam, China
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Objective To evaluate the efficacy of a treatment strategy that actively integrates imaging features and serum biomarkers into CEUS-guided microwave ablation (MWA) for hepatocellular carcinoma (HCC). Methods A comprehensive literature search was conducted, and randomized controlled trials (RCTs) meeting the inclusion criteria were selected. The methodological quality of the included studies was assessed using the Cochrane Risk of Bias Tool, and RevMan 5.3 software was employed for meta-analysis. The primary endpoints included complete tumor ablation rate, local recurrence rate (LRR), local progression rate (LPR), recurrence-free survival (RFS), and complication rate. Results A total of 7 RCTs involving 1,039 HCC patients (407 in the treatment group, 632 in the control group) were included. Meta-analysis demonstrated the following: The complete ablation rate was significantly higher in the treatment group than in the control group (RR=1.06 , 95%CI [1.01, 1.10] , P=0.010).The local recurrence rate was significantly lower in the treatment group (RD=-0.09 , 95%CI [-0.17, -0.01] , P=0.02).No significant differences were observed in RFS (RR=1.11 , 95%CI [1.00, 1.24] , P= 0.06), LPR (RR=1.55 , 95%CI [0.78, 3.07] , P=0.21), or complication rates (RR=1.13 , 95%CI [0.66, 1.91] , P=0.66) between the two groups. Heterogeneity among studies was low (I²≤34%), and funnel plot analysis indicated minimal publication bias. Conclusion CEUS-guided MWA combined with imaging features and serum biomarkers is associated with significant improvements in complete tumor ablation rates and is associated with a reduction in local recurrence. This strategy provides evidence-based support for optimizing precision local control in HCC, but its impact on long-term survival requires validation through future studies with extended follow-up.
Keywords: hepatocellular carcinoma (HCC), Contrast-enhanced ultrasound (CEUS), microwave ablation (MWA), Imaging features, Serum biomarkers, Meta-analysis
Received: 16 Aug 2025; Accepted: 20 Oct 2025.
Copyright: © 2025 Zou, Shang, Song, Deng and Lu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Lin Lu, luhuai2000@126.com
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