| Title | Vascularization and perfusion of hepatocellular carcinoma: assessment with contrast-enhanced ultrasound using perflutren protein-type A microspheres. | | Author(s) | Jung EM, Kubale R, Jungius KP | | Institution | Institute of Diagnostic Radiology, Passau Hospital - Teaching Hospital of the University of Regensburg, Germany. | | Source | Clin Hemorheol Microcirc 2005; 33(1):63-73. | | MeSH | Adult
Aged
Blood Vessels
Carcinoma, Hepatocellular
Chemoembolization, Therapeutic
Comparative Study
Contrast Media
Diagnostic Imaging
Fluorocarbons
Humans
Microspheres
Middle Aged
Predictive Value of Tests
Reperfusion
Sensitivity and Specificity
Staphylococcal Protein A
Ultrasonography
| | Abstract | PURPOSE: To assess the vascularization and the perfusion within hepatocellular carcinoma (HCC) including treatment-related changes with contrast-enhanced (CE) ultrasound (US).
MATERIALS AND METHODS: Twenty-six biopsy-verified HCC lesions (size between 2.5-8 cm, median 3.8 cm) in 20 patients were examined with unenhanced and CE vascular US techniques immediately before selective angiography for transarterial chemoembolization (TACE) as well as immediately after TACE using all of the following modalities: color-coded Doppler sonography (CCDS), power Doppler imaging (PDI), CE pulse inversion harmonic imaging with PDI (PIHI+PDI), and CE coded harmonic angiography (CHA). In CE US studies, perflutren protein-type A microspheres were administered as contrast agent in a single 0.5 ml i.v. bolus diluted in 20 ml 0.9% NaCl. Selective arteriograms and CE computed tomographies were taken for reference purposes. The Wilcoxon test was used for statistical analysis.
RESULTS: Intratumoral vessels could be visualized before TACE in 11/26 lesions (42%) with CCDS; in 15/26 (58%) with PDI; in 23/26 (88%) with CE CHA; in 26/26 (100%) with CE PIHI+PDI. Following TACE, the sensitivities were calculated as follows: CCDS 33%; PDI 55%; CE CHA 77%; and CE PIHI+PDI 100%. The corresponding negative predictive values were 74% for CCDS; 81% for PDI; 89% for CE CHA and 100% for CE PIHI+PDI. During the capillary phase, contrast enhancement could be observed in the CHA mode only.
CONCLUSION: CE US by means of PIHI+PDI and CHA enables reliable visualization of residual tumor following TACE equivalent to that which is attained with angiography and Contrast Harmonic Imaging with Power Doppler, if perflutren microspheres are used as contrast agent in a single low-dose bolus. | | Language | eng | | Pub Type(s) | Clinical Trial
Journal Article
| | PubMed ID | 16037634 |
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