Use of contrast-enhanced ultrasonography with a perflubutane-based contrast agent performed one day after transarterial chemoembolization for the early assessment of residual viable hepatocellular carcinoma

• Published in: European journal of radiology Vol. 82; no. 9; pp. 1471 - 1480
• Main Authors: Takizawa, Kenichi, Numata, Kazushi, Morimoto, Manabu, Kondo, Masaaki, Nozaki, Akito, Moriya, Satoshi, Ishii, Tomohiro, Oshima, Takashi, Fukuda, Hiroyuki, Okada, Masahiro, Takebayashi, Shigeo, Maeda, Shin, Tanaka, Katsuaki
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.09.2013
• Subjects: Aged; Aged, 80 and over; Antineoplastic Agents - therapeutic use; Carcinoma, Hepatocellular - diagnostic imaging; Carcinoma, Hepatocellular - therapy; Chemoembolization, Therapeutic - methods; Contrast Media; Contrast-enhanced ultrasonography; Early Diagnosis; Female; Hepatocellular carcinoma; Humans; Iopamidol; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - therapy; Male; Middle Aged; Neoplasm, Residual; Organoplatinum Compounds - therapeutic use; Radiology; Reproducibility of Results; Sensitivity and Specificity; Transarterial chemoembolization; Treatment Outcome; Ultrasonography; Hepatocellular carcinoma; Contrast-enhanced ultrasonography; Transarterial chemoembolization
• ISSN: 0720-048X; 1872-7727; 1872-7727
• DOI: 10.1016/j.ejrad.2013.04.045

We evaluated the efficacy of contrast-enhanced ultrasonography (US), compared with contrast-enhanced computed tomography (CT), for early assessments after transarterial chemoembolization (TACE) for the treatment of hypervascular hepatocellular carcinoma (HCC) lesions. Thirty-two patients with 59 HCC lesions who were scheduled to receive TACE were enrolled in this prospective study. TACE was performed by injecting a mixture of iodized oil and miriplatin hydrate, followed by a gelatin sponge. Digital subtraction angiography (DSA) and/or contrast-enhanced CT were performed 2–6 months after TACE and were used as the reference standard for residual HCC; the detection rates for residual viable HCC using contrast-enhanced US with a perflubutane-based contrast agent and a high mechanical index (MI) mode performed one day after TACE were also compared with those obtained using contrast-enhanced CT performed one month after TACE. The comparisons were made using the McNemar test. Forty-seven (79.7%) of the 59 HCC lesions were diagnosed as having residual viability based on DSA and contrast-enhanced CT findings obtained 2–6 months after TACE. Eight (17.0%) of the 47 HCC lesions that were diagnosed as having residual viability using one-day contrast-enhanced US were not detected using one-month contrast-enhanced CT because of artifacts produced by the high attenuation of the iodized oil. The detection rate for residual HCC lesions using one-day contrast-enhanced US (95.7%, 45/47) was significantly higher than that using one-month contrast-enhanced CT (78.7%, 37/47) (P<0.05). Contrast-enhanced US performed one day after TACE is more sensitive than contrast-enhanced CT performed one month after TACE for detecting residual viable HCC.