Evaluation of Posttreatment Response of Hepatocellular Carcinoma with Contrast-enhanced Coded Phase-Inversion Harmonic US: Comparison with Dynamic CT

Ding, Hong; Kudo, Masatoshi; Onda, Hirokazu; Suetomi, Yoichiro; Minami, Yasunori; Chung, Hobyung; Kawasaki, Toshihiko; Maekawa, Kiyoshi

doi:10.1148/radiol.2213010358

Cited by 129 publications

(98 citation statements)

References 21 publications

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“…Studies have now shown that HBV genotype correlates with the risk for HCC and that genotype C carries two-to threefold higher risk than genotype B in developing HCC [10,[14][15][16][17][18][19]. Other HBV variants, such as precore, basal core, and pre-S deletion mutants, may also influence the development of HCC in carriers [15,[19][20][21][22][23][24][25].…”

Section: Hepatitis B Infectionmentioning

confidence: 99%

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

et al. 2010

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Introduction The Asian Pacific Association for the Study of the Liver (APASL) convened an international working party on the management of hepatocellular carcinoma (HCC) in December 2008 to develop consensus recommendations. Methods The working party consisted of expert hepatologist, hepatobiliary surgeon, radiologist, and oncologist from Asian-Pacific region, who were requested to make drafts prior to the consensus meeting held at Bali, Indonesia on 4 December 2008. The quality of existing evidence and strength of recommendations were ranked from 1 (highest) to 5 (lowest) and from A (strongest) to D (weakest), respectively, according to the Oxford system of evidence-based approach for developing the consensus statements. 123Hepatol Int (2010) 4: 439-474 DOI 10.1007/s12072-010-9165-7 Results Participants of the consensus meeting assessed the quality of cited studies and assigned grades to the recommendation statements. Finalized recommendations were presented at the fourth APASL single topic conference on viral-related HCC at Bali, Indonesia and approved by the participants of the conference.

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Section: Hepatitis B Infectionmentioning

confidence: 99%

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

et al. 2010

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“…In the management of HCC, despite advances in diagnostic imaging techniques such as ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI), many difficulties remain, such as screening, staging, evaluation of treatment response, treatment guidance, identification of local recurring nodules after treatment, and diagnosis of intrahepatic recurrence after treatment. In fact, among these problems, Levovist-enhanced US has made a certain contribution to differential diagnosis [1,2,3], evaluation of malignancy grade [4], evaluation of therapeutic response to transcatheter arterial chemoembolization (TACE) [5,6,7], and needle insertion guidance [8,9]. However, there are still significant limitations in the evaluation of the therapeutic response to radiofrequency ablation (RFA) [10], screening or staging.…”

Section: Introductionmentioning

confidence: 99%

Newly Developed Novel Ultrasound Technique, Defect Reperfusion Ultrasound Imaging, Using Sonazoid in the Management of Hepatocellular Carcinoma

Kudo¹,

Hatanaka²,

Maekawa

2010

Oncology

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The aim of this study is to clarify the usefulness of defect reperfusion ultrasound (US) imaging using Sonazoid in the management of hepatocellular carcinoma (HCC). A total of 33 HCC nodules and 34 local recurring nodules after radiofrequency ablation (RFA), which could not be identified by B-mode US but were depicted by dynamic CT, were studied by defect reperfusion US imaging with Sonazoid. In addition, Kupffer phase Sonazoid-enhanced US in combination with defect reperfusion US imaging were used for screening HCC in 262 consecutive cirrhotic patients. As a result, 33 US undetectable HCC nodules and 34 local recurring HCC nodules were successfully confirmed by Sonazoid-enhanced US with defect reperfusion imaging. Subsequently, RFA was successfully performed in all of 67 HCC nodules with a Sonazoid-enhanced US guidance. A total of 7 small HCCs were depicted and confirmed as HCCs by Kupffer phase surveillance and defect reperfusion US imaging. In conclusion, defect reperfusion US imaging is extremely useful in the depiction and confirmation of US undetectable HCCs as well as in the surveillance of HCC in cirrhotic patients.

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“…Among these problems, Levovist-enhanced US has made a certain contribution to differential diagnosis [5,6,7], evaluation of malignancy grade [8], evaluation of therapeutic response to transcatheter arterial chemoembolization (TACE) [9,10,11], and needle insertion guidance [12, 13]; however, there are still remarkable limitations in the evaluation of the therapeutic response to radiofrequency ablation [14], screening or staging.…”

Section: Newly Introduced Diagnostic Techniquesmentioning

confidence: 99%

Hepatocellular Carcinoma 2009 and Beyond: from the Surveillance to Molecular Targeted Therapy

Kudo

2008

Oncology

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Hepatocellular carcinoma (HCC) is a malignant tumor which is becoming more prevalent worldwide. Patients at high risk of developing HCC, namely hepatitis B- and C-related liver cirrhosis patients, should be entered into surveillance programs, which should be performed using both ultrasonography and 3 tumor markers (AFP, PIVKA-II, AFP-L3). The surveillance interval needs to be shortened for patients at higher risk of HCC. Therefore, super-high-risk patients should be screened at 3- to 4-month intervals based on their risk of developing HCC. Sonazoid-enhanced US is extremely useful to characterize hepatic tumors when compared with multidetector-row computed tomography (MDCT). Moreover, Sonazoid-enhanced US with defect reperfusion imaging is a breakthrough approach in the treatment of HCC. This technique will markedly change the therapeutic strategy for liver cancer. Furthermore, diagnostic capability using the new imaging technique Gd-EOB-DTPA MRI is promising. A reduced uptake (low intensity) in the hepatobiliary phase of Gd-EOB-DTPA MRI strongly suggests HCC (including early-stage HCC) or a high-grade dysplastic nodule with high malignant potential. Empirically, intrahepatic arterial infusion chemotherapy using implanted reservoir port is known to be effective for advanced HCC with vascular invasion; however, no randomized study exists to prove its efficacy. Further controlled study is necessary to establish this treatment option as a standard of care in a treatment algorithm for HCC. In contrast, sorafenib was established as the first choice of treatment as a standard of care in advanced HCC patients with preserved liver function and vascular invasion/extrahepatic spread. Furthermore, global clinical trials are now ongoing using sorafenib as an adjuvant setting after resection, ablation or TACE. Efficacy of combined use of sorafenib with TACE or intra-arterial infusion chemotherapy is not clear. In order to clarify this issue a randomized clinical trial for intermediate and advanced HCC comparing sorafenib alone versus sorafenib combined with maintenance TACE/intra-arterial infusion chemotherapy and/or intra-arterial infusion chemotherapy is scheduled to be initiated in Japan in 2009. If positive results are obtained by these trials, its impact on treatment strategy for HCC will be drastically changed.

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Evaluation of Posttreatment Response of Hepatocellular Carcinoma with Contrast-enhanced Coded Phase-Inversion Harmonic US: Comparison with Dynamic CT

Abstract: With enhancement, coded harmonic US depicted tumor vascularity by showing tumor vessels in a real-time fashion at continuous imaging and tumor parenchymal flow at interval-delay scanning.

Cited by 129 publications

References 21 publications

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

Newly Developed Novel Ultrasound Technique, Defect Reperfusion Ultrasound Imaging, Using Sonazoid in the Management of Hepatocellular Carcinoma

Hepatocellular Carcinoma 2009 and Beyond: from the Surveillance to Molecular Targeted Therapy

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