Assessment of the Therapeutic Response of Hepatocellular Carcinoma Treated With Transcatheter Arterial Chemoembolization

Abstract

Contrast-enhanced sonography is a more sensitive imaging method than 3-phase CT in depicting vascularity in HCCs treated with TACE.

Contrast-Enhanced Ultrasound Techniques for Guiding and Assessing Response to Locoregional Treatments for Hepatocellular Carcinoma

“…Since April 1998, 34 studies [35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69] that consider different CEUS techniques have been published. Of these, 23 were on harmonic gray-scale CEUS [48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70], 12 were on Doppler CEUS modalities [36,37,38,39,40,41,42,43,44,45,46,47,48], one study compared both approaches [48] and another reported on carbon dioxide CEUS [35] Two studies have been excluded from our discussion due to the unavailability of papers [71,72].…”

“…Of these, 23 were on harmonic gray-scale CEUS [48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70], 12 were on Doppler CEUS modalities [36,37,38,39,40,41,42,43,44,45,46,47,48], one study compared both approaches [48] and another reported on carbon dioxide CEUS [35] Two studies have been excluded from our discussion due to the unavailability of papers [71,72]. …”

“…Studies published on harmonic gray-scale CEUS for assessing the response to locoregional treatments encompass a total of 1,244 enrolled patients [42,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70]. Posttreatment assessment was made on 1,314 nodules in 16 studies following RFA [42,49,50,54,55,56,57,59,61,63,65,66,67,68,69,70], in 3 studies following PEI [57,59,67], and in 11 studies following TACE [49,50,51,52,53,57,60,62,64,66,69].…”

“…Posttreatment assessment was made on 1,314 nodules in 16 studies following RFA [42,49,50,54,55,56,57,59,61,63,65,66,67,68,69,70], in 3 studies following PEI [57,59,67], and in 11 studies following TACE [49,50,51,52,53,57,60,62,64,66,69]. Five of these studies also contemplated the use of combined treatments [49,50,57,67,69].…”

Image Guided Procedures and Response Assessment It is Time to Move from Anatomic to Physiologic Imaging

“…Recently emerging cone beam CT angiography systems also allow real time multi-planar fusion of angiography with any DICOM (Digital Imaging and Communications in Medicine) imaging data, for guidance during fluoroscopic/angiographic procedures such as biopsies, TACE and Tumor Ablation [16]. Ultrasound contrast agents, consisting of a gas core encapsulated by a shell of lipid monolayer or cross-linked albumin [17], may also be used for real time guidance depicting tumor vascularity sensitively and accurately [18,19,20]. To date, no Ultrasound contrast agents have received approval from the FDA for radiological applications in the USA and only two are approved for cardiac left ventricular opacification.…”