Clinical studyContrast-enhanced Ultrasound as a Predictor of Treatment Efficacy within 2 Weeks after Transarterial Chemoembolization of Hepatocellular Carcinoma
Section snippets
Patients
Thirty-three cirrhotic patients (21 male, 12 female) with known HCC scheduled for TACE were included. The diagnosis of HCC was confirmed via biopsy and/or liver transplantation in 18 patients: needle biopsy or aspiration (n = 9), liver transplantation (n = 5), autopsy (n = 2), and resection (n = 2). The other 15 patients had probable diagnosis via characteristic imaging finding with increased tumor marker (AFP >400 ng/mL and/or PIVKA-II >100 mAU/mL) (15) (n = 7) and presumed diagnosis via more
Results
Each CEUS study consisted of an average of 4.7 ± 1.6 injections of 0.5 to 2 mL USCM for an average total volume of 6.2 ± 2.6 mL per study. No change in blood pressure, pulse rate, or temperature was observed in any patient, and there were no symptoms or untoward effects reported. Optison and Imagent were used in 11 and 31 studies, respectively. The two sonologists performing the CEUS agreed with regard to the presence or absence of residual tumor flow in all cases in this study.
Although we did
Discussion
If CEUS performed within days after TACE is as sensitive and specific as we have shown in this study, it would not only be superior to CECT and CEMRI performed in the same time period but would also be a more attractive alternative, as sonography is practical, inexpensive, accessible, and can be performed repeatedly at the bedside. Based on our results, we believe that CEUS would be an ideal test for selecting patients with unresectable tumors and those awaiting liver transplantation for
Acknowledgments
This work was supported in part by an American Liver Foundation Scholar Award (Y.K.); by IMCOR Pharmaceutical Corp. (San Diego, Calif), which provided contrast media; and by Siemens Ultrasound (Issaquah, Wash), which provided equipment. The paper was presented at the Radiological Society of North America (RSNA) meeting in November 2004.
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None of the authors have identified a conflict of interest.