Quantification of tumor vascularity with contrast-enhanced ultrasound for early response of transcatheter arterial chemoembolization for hepatocellular carcinoma: a report of three cases

Abstract

Many contrast-enhanced ultrasound (CE-US) studies have been conducted by qualitative analysis of blood flow, such as classification of enhancement pattern. We evaluated early response of transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) by quantitative analysis of intratumoral vascularity with CE-US in three patients. Three patients (one man, two women) with HCCs were treated in July 2009. CE-US with perfluorocarbon microbubbles (Sonazoid) and CT were performed serially before and 5 days after TACE. Post-processing enhancement intensity on US was analyzed to determine mean transit time (s), time to peak (s), enhancement peak intensity (dB), and "A" (scaling factor) by ultrasound quantification software after the data were fitted to a gamma variate curve. Mean transit time was prolonged by TACE in all three patients. Mean transit time rates on CE-US were 64.3, 33.8, and 65.6%, respectively, whereas the avascular rates on CT were 59.07, 31.71, and 62.25%, respectively. Mean transit time rates on CE-US approximated avascular rates on CT. Mean transit time rate may quantitatively indicate the early response of HCC to TACE.

Utility of Contrast‐Enhanced Ultrasound for Early Therapeutic Evaluation of Hepatocellular Carcinoma After Transcatheter Arterial Chemoembolization

“…Several studies have reported that CEUS could detect viable HCC after TACE more sensitively than CECT. 10,[16][17][18][19][20][21][22][23][24] Although many previous studies have reported the usefulness of CEUS performed more than several weeks after TACE, there are few studies that have reported the usefulness of CEUS for the early evaluation of the treatment response of HCC to TACE. 16,23,24 The aim of this study was to investigate the utility of CEUS for early evaluation of the treatment response of HCC to TACE.…”

“…Contrast‐enhanced US may therefore have advantages in the early assessment of TACE efficacy in HCC. Several studies have reported that CEUS could detect viable HCC after TACE more sensitively than CECT . Although many previous studies have reported the usefulness of CEUS performed more than several weeks after TACE, there are few studies that have reported the usefulness of CEUS for the early evaluation of the treatment response of HCC to TACE .…”

Defect Reperfusion Imaging with Sonazoid®: A Breakthrough in Hepatocellular Carcinoma

“…These defects can be treated by RFA. Kupffer phase Sonazoid ® -enhanced US-guided RFA is possible in almost all cases of HCC that are not identified by B-mode US, with a sensitivity as high as 100% [30][31][32][33][34].…”