Assessment of hepatocellular carcinoma by contrast-enhanced ultrasound with perfluorobutane microbubbles: comparison with dynamic CT

Abstract

Objective: The aim of this study was to evaluate tumour vascularity and Kupffer cell imaging in hepatocellular carcinoma (HCC) using contrast-enhanced ultrasonography (CEUS) with Sonazoid (perfluorobutane) and to compare performance with dynamic CT. Methods: We studied 118 nodules in 88 patients with HCC. HCC was diagnosed as a hyperenhancement lesion in the arterial phase with washout in the portal phase on dynamic CT or by percutaneous biopsy. We observed tumour vascularity at the early vascular phase (10-30 s after contrast injection) and Kupffer imaging at the postvascular phase (after 10 min). Results: Detection of vascularity at the early vascular phase was 88% in nodules that were found to be hypervascular on dynamic CT and 28% in hypo-/isovascular nodules; the detection of local recurrence nodules was 92%. The detection of vascularity was significantly lower in nodules .9 cm deep than in those #9 cm deep, but was not affected by tumour size. The detection of tumours at the post-vascular phase on CEUS was 83% in nodules with low density in the portal phase on dynamic CT and 82% in nodules with isodensity. The rate did not depend on the severity of underlying liver disease; rates decreased in nodules deeper than 9 cm, those smaller than 2 cm in diameter and in iso-enhancing nodules at the early vascular phase of CEUS. Conclusion: CEUS with Sonazoid is a useful tool for assessing the vascularity of HCC and is equal to that of dynamic CT; however, the detectability of HCC vascularity is affected by location.

Usefulness of contrast‐enhanced ultrasonography using Sonazoid for the assessment of therapeutic response to percutaneous radiofrequency ablation for hepatocellular carcinoma

“…A number of studies have reported the benefits of contrast‐enhanced US (CEUS) using contrast agents for appraising hepatic hemodynamics and assessing therapeutic effects . In particular, a recently developed second‐generation contrast agent, Sonazoid (Daiichi‐Sankyo, Tokyo, Japan) has attracted attention owing to its capacity for real‐time observation for prolonged periods . Sonazoid is an ultrasound contrast agent consisting of an aqueous suspension of lipid‐stabilized perfluorobutane‐filled gas microbubbles.…”

Usefulness of contrast‐enhanced ultrasound with Sonazoid for evaluating liver abscess in comparison with conventional B‐mode ultrasound

“…8,9 The advent of Sonazoid, a secondgeneration contrast agent (perfluorobutane; Diichi Sankyo, Tokyo, Japan), enables low mechanical index (MI) continuous real-time imaging and Kupffer imaging. 9,10 Contrast-enhanced US (CEUS) with Sonazoid has dramatically improved the detection of liver malignancies. [9][10][11] It can assess in real time the vascularity of the hepatic artery and the portal vein in the vascular phase and the presence of Kupffer cells in the post-vascular phase.…”

Contrast-enhanced sonography in pediatrics

“…We concluded that bevacizumab transiently improved tumor vascularity, with a subsequent increase in tumor blood flow, early after its administration but eventually reduces tumor perfusion. Such information could be important in scheduling conventional chemotherapy to optimize intratumoral drug delivery [25].…”