Pilot study evaluating catheter-directed contrast-enhanced ultrasound compared to catheter-directed computed tomography arteriography as adjuncts to digital subtraction angiography to guide transarterial chemoembolization

Burgmans, Mark C.; Erkel, Arian R. van; Too, Chow Wei; Coenraad, Minneke J.; Lo, R.; Tan, Bien-Soo

doi:10.1016/j.crad.2014.06.001

Cited by 7 publications

(5 citation statements)

References 16 publications

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“…A few centers have employed direct intra-arterial administration of microbubble contrast agents (intra-arterial CEUS) during transarterial liver tumor interventions such as TACE to assess tumor vascular supply. Burgmans et al (57) performed a pilot study in which they performed intra-arterial CEUS along with digital subtraction angiography from the proper hepatic, segmental, and subsegmental arterial positions during TACE. They found that intra-arterial CEUS changed the treatment plan in almost half of patients, whether by identifying additional tumor feeding vessels or resulting in a change in catheter position, with results similar to those provided by catheter-directed CT hepatic angiography.…”

Section: Intra-arterial Ceus During Tacementioning

confidence: 99%

Contrast-enhanced US for the Interventional Radiologist: Current and Emerging Applications

et al. 2020

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US is a powerful and nearly ubiquitous tool in the practice of interventional radiology. Use of contrast-enhanced US (CEUS) has gained traction in diagnostic imaging given the recent approval by the U.S. Food and Drug Administration (FDA) of microbubble contrast agents for use in the liver, such as sulfur hexafluoride lipid-type A microspheres. Adoption of CEUS by interventional radiologists can enhance not only procedure guidance but also preprocedure patient evaluation and assessment of treatment response across a wide spectrum of oncologic, vascular, and nonvascular procedures. In addition, the unique physical properties of microbubble contrast agents make them amenable as therapeutic vehicles in themselves, which can lay a foundation for future therapeutic innovations in the field in drug delivery, thrombolysis, and vascular flow augmentation. The purpose of this article is to provide an introduction to and overview of CEUS aimed at the interventional radiologist, highlighting its role before, during, and after frequently practiced oncologic and vascular interventions such as biopsy, ablation, trans arterial chemoembolization, detection and control of hemorrhage, evaluation of transjugular intrahepatic portosystemic shunts (TIPS), detection of aortic endograft endoleak, thrombus detection and evaluation, evaluation of vascular malformations, lymph angiography, and percutaneous drain placement. Basic physical principles of CEUS, injection and scanning protocols, and logistics for practice implementation are also discussed. Early adoption of CEUS by the interventional radiology community will ensure rapid innovation of the field and development of future novel procedures.

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Section: Intra-arterial Ceus During Tacementioning

confidence: 99%

Contrast-enhanced US for the Interventional Radiologist: Current and Emerging Applications

et al. 2020

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“…Information similar to that provided by IAUS may be acquired using CTA and cone-beam CT. Oblique acquisition may also be performed to define the positional relationship of the tumor on DSA, but the procedure is complicated and time-consuming, and increases the exposure dose and contrast medium volume, all of which are disadvantageous[ 15 , 30 ]. Also, renal function is decreased in many patients with hepatic cirrhosis, and worsens with iodine contrast medium.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of intra-arterial contrast-enhanced ultrasonography during transarterial chemoembolization with drug-eluting beads for hepatocellular carcinoma

Shiozawa¹,

Watanabe²,

Ikehara³

et al. 2018

WJH

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AIMTo assess the usefulness of intra-arterial contrast-enhanced ultrasonography (IAUS) during transarterial chemoembolization (TACE) with drug-eluting beads (DEB) for hepatocellular carcinoma (HCC).METHODSThirty two patients with 39 HCC underwent DEB-TACE guided with IAUS, and examined by contrast-enhanced ultrasonography (CEUS) or dynamic CT after DEB-TACE were enrolled in this study. CEUS findings before DEB-TACE and IAUS findings were compared. Treatments judged to be complete and incomplete for lesions were appropriate and insufficient, respectively. Findings on CEUS and/or dynamic CT performed 1, 3 and 6 mo after DEB-TACE were evaluated using mRECIST (CR/PR/SD/PD).RESULTSThe treatments were complete and incomplete in 26 and 13 lesions, respectively. On imaging evaluation using CEUS and/or dynamic CT one month after treatment, 25 and 1 lesions were judged to be CR and PR, respectively, and at 6 mo after treatment, the results were CR, PR, SD and PD for 24, 1, 0 and 1 of these lesions, respectively, in the 26 completely treated lesions. Of the 13 lesions in which treatment was incomplete, the results on imaging at one month after treatment were CR, PR, SD and PD for 0, 6, 4 and 3 lesions, respectively. The overall CR rate at 6 mo after treatment was 61.5% (24/39).CONCLUSIONA combination of DEB-TACE with IAUS can improve the therapeutic effects in patients with HCC.

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“…Indeed, when nonenhancing areas are located anteriorly or posteriorly, they are not appreciable with two-dimensional angiography. Burgmans et al [57] proposed injecting microbubbles under US guidance directly through the intraarterial catheter in order to have a multiplanar visualization before TACE. A modification in the treatment approach occurred in 44.4% of cases due to the additional information provided by this technique, which was consistent with catheter-directed CT arteriography, used as a reference for intrahepatic findings.…”

Section: Guidance and Evaluation Of Hcc Treatmentsmentioning

confidence: 99%

Imaging Diagnosis of Hepatocellular Carcinoma: Recent Advances of Contrast-Enhanced Ultrasonography with SonoVue®

et al. 2015

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Due to the ability to detect the typical contrast-imaging pattern for hepatocellular carcinoma (HCC), that is hyperenhancement in the arterial phase and hypoenhancement in the late phase on a cirrhotic background, contrast-enhanced ultrasonography (CEUS) was included in the American diagnostic algorithm for HCC in 2005. However, its role has been questioned because of the possibility of misdiagnosis of cholangiocarcinoma. The present review aims to describe the advantages and disadvantages of CEUS applications using Sonovue® for HCC. In particular there is focus on the accuracy of CEUS in detecting the typical HCC pattern, the CEUS patterns of intrahepatic cholangiocarcinoma (ICC), the risk of misdiagnosis with HCC, the diagnostic use of CEUS in cases of locoregional and systemic treatments, and the evaluation of response to antiangiogenic treatment using dedicated software.

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Pilot study evaluating catheter-directed contrast-enhanced ultrasound compared to catheter-directed computed tomography arteriography as adjuncts to digital subtraction angiography to guide transarterial chemoembolization

Abstract: CCEUS is a potentially valuable imaging tool in adjunction to DSA when performing TACE and may provide similar information to CCTA.

Cited by 7 publications

References 16 publications

Contrast-enhanced US for the Interventional Radiologist: Current and Emerging Applications

Contrast-enhanced US for the Interventional Radiologist: Current and Emerging Applications

Efficacy of intra-arterial contrast-enhanced ultrasonography during transarterial chemoembolization with drug-eluting beads for hepatocellular carcinoma

Imaging Diagnosis of Hepatocellular Carcinoma: Recent Advances of Contrast-Enhanced Ultrasonography with SonoVue®

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