Abstract: Objective The aim of this study was to investigate the prediction of complete remission (CR) by contrast-enhanced ultrasonography (CEUS) and serum prothrombin induced by vitamin K absence-II (PIVKA-II) levels in elderly patients with hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE) therapy. Method 87 elderly patients with HCC were encountered in the First Affiliated Hospital, Air Force Medical University between March 2020 and March 2023, and all underwent CEUS to detect the rise time (RT), time to peak (TTP) and maximum of intensity (IMAX). Serum PIVKA-II levels were routinely assayed. Based on appropriate preparing, the TACE was conducted for every patient. The receiver operating characteristic (ROC) curve was applied to predict the efficacy of TACE. Result Out of the 87 patients with HCC, the CR was obtained in 27 cases(31.0%), and the partial remission, stable disease and progression disease were found in 19 cases, 28 cases and 13 cases, e.g., the non-CR rate was 69.0%; before TACE, the TTP by CEUS in patients with CR was (35.3±3.2)s, significantly longer than [(18.3±3.5)s, P＜0.05], while serum PIVKA-Ⅱ level was (1253.7±307.4)mAU/mL, much lower than [(2784.1±221.7)mAU/mL, P＜0.05] in patients with non-CR; the ROC analysis showed that the predicting performance of the combination of TTP and serum PIVKA-II level for CR after TACE was promising, with the sensitivity of 96.3% and the specificity of 88.3%, much superior to any parameters of the two alone (P<0.05). Conclusion Both the CEUS and serum PIVKA-II level could be used to predict CR in elderly patients with HCC after TACE, which needs further multi-center clinical study for verification.

Key words: Hepatoma, Transcatheter arterial chemoembolization, Contrast-enhanced ultrasonography, Time to peak, Prothrombin induced by vitamin K absence-II, Complete Remission