Ultrasound localization microscopy for evaluation of therapeutic efficacy assessment after transarterial chemoembolization in hepatocellular carcinoma

Objectives The timely and precise evaluation of the efficacy of Transarterial chemoembolization (TACE) in hepatocellular carcinoma (HCC) patients facilitates post preventive and therapeutic therapy. This study aimed to demonstrate the significance of ultrasound localization microscopy (ULM) assessment of TACE. Methods A total of 85 HCC patients underwent initial TACE were retrospectively analyzed. The ULM system automatically calculated relevant metrics, including vessel ratio, mean velocity, and perfusion index. A combined evaluation model was constructed by ULM parameters alongside routine laboratory indicators (AFP, WBC, RBC, ALP) selected via Random Forest and Logistic algorithm. Results The combined model achieved an Area Under the Curve (AUC) of 0.915 in assessing TACE efficacy. The model demonstrated excellent calibration with a mean absolute error of 0.076 in clinic decision probabilities. Conclusion ULM effectively reflects changes in the tumor vasculature in patients with HCC after TACE. Combining with WBC, RBC, ALP, and elevated AFP levels could improve evaluation performance.