The usefulness of contrast-enhanced ultrasonography in the early detection of hepatocellular carcinoma viability after transarterial chemoembolization: pilot study.
10.3350/cmh.2015.21.2.165
- Author:
Youn Zoo CHO
1
;
So Yeon PARK
;
Eun Hee CHOI
;
Soon Koo BAIK
;
Sang Ok KWON
;
Young Ju KIM
;
Seung Hwan CHA
;
Moon Young KIM
Author Information
1. Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea. drkimmy@yonsei.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Hepatocellular carcinoma;
Transarterial chemoembolization;
Contrast-enhanced ultrasonography;
Computed tomography;
Magnetic resonance imaging
- MeSH:
Aged;
Aged, 80 and over;
Antineoplastic Agents/administration & dosage;
Carcinoma, Hepatocellular/pathology/therapy/*ultrasonography;
Chemoembolization, Therapeutic;
Contrast Media/*chemistry;
Female;
Gadolinium DTPA/chemistry;
Humans;
Liver Neoplasms/pathology/therapy/*ultrasonography;
Magnetic Resonance Imaging;
Male;
Middle Aged;
Pilot Projects;
Tomography, X-Ray Computed;
Treatment Outcome
- From:Clinical and Molecular Hepatology
2015;21(2):165-174
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: The therapeutic effect of transarterial chemoembolization (TACE) against hepatocellular carcinoma (HCC) is usually assessed using multidetector computed tomography (MDCT). However, dense lipiodol depositions can mask the enhancement of viable HCC tissue in MDCT. Contrast-enhanced ultrasonography (CEUS) could be effective in detecting small areas of viability and patency in vessels. We investigated whether arterial enhancement in CEUS after treatment with TACE can be used to detect HCC viability earlier than when using MDCT. METHODS: Twelve patients received CEUS, MDCT, and gadoxetic-acid-enhanced dynamic magnetic resonance imaging (MRI) at baseline and 4 and 12 weeks after TACE. The definition of viable HCC was defined as MRI positivity after 4 or 12 weeks. RESULTS: Eight of the 12 patients showed MRI positivity at 4 or 12 weeks. All patients with positive CEUS findings at 4 weeks (n=8) showed MRI positivity and residual viable HCC at 4 or 12 weeks. Five of the eight patients with positive CEUS findings at 4 weeks had negative results on the 4-week MDCT scan. Four (50%) of these eight patients did not have MRI positivity at 4 weeks and were ultimately confirmed as having residual HCC tissue at the 12-week MRI. Kappa statistics revealed near-perfect agreement between CEUS and MRI (kappa=1.00) and substantial agreement between MDCT and MRI (kappa=0.67). CONCLUSIONS: In the assessment of the response to TACE, CEUS at 4 weeks showed excellent results for detecting residual viable HCC, which suggests that CEUS can be used as an early additive diagnosis tool when deciding early additional treatment with TACE.
