Evaluation of local recurrence after treatment for hepatocellular carcinoma by contrast‐enhanced ultrasonography using Sonazoid: Comparison with dynamic computed tomography

Shiozawa, Kazue; Watanabe, Manabu; Takayama, Ryuji; Takahashi, Masayoshi; Wakui, Noritaka; Iida, Kazunari; Sumino, Yasukiyo

doi:10.1002/jcu.20685

Cited by 37 publications

(39 citation statements)

References 31 publications

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“…28 Several studies have been published exploring the use of contrast-enhanced US as a tool for evaluating transarterial chemoembolization. [16][17][18][19][20][21][22][23][24] Kono et al 17 performed contrastenhanced US imaging in 42 lesions treated with ethiodol transarterial chemoembolization and found no falsenegative results and only 1 false-positive result in the 33 completed studies. Follow-up imaging times varied from 1 day to 4 weeks, and the only false-positive result occurred at 1 day (presumably due to the presence of gas immediately after treatment).…”

Section: Discussionmentioning

confidence: 99%

“…13 Several studies have been published exploring the use of contrast-enhanced US as a tool for early monitoring of conventional transarterial chemoembolization, with a lack of tumor enhancement correlating well with an avascular treatment response. [16][17][18][19][20][21][22][23][24] However, few of these reports have investigated the ability of contrast-enhanced US to evaluate transarterial chemoembolization with drug-eluting beads, and optimal imaging times remain poorly defined. Additionally, the use of an FDA-approved US contrast agent to evaluate hepatocellular carcinoma treated with drug-eluting beads has yet to be investigated.…”

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confidence: 99%

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Contrast‐Enhanced Ultrasound Evaluation of Residual Blood Flow to Hepatocellular Carcinoma After Treatment With Transarterial Chemoembolization Using Drug‐Eluting Beads

Shaw

Eisenbrey

Lyshchik

et al. 2015

J of Ultrasound Medicine

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Objectives-To evaluate the accuracy and change over time of contrast-enhanced ultrasound (US) imaging for assessing residual blood flow after transarterial chemoembolization of hepatocellular carcinoma with drug-eluting beads at 2 different follow-up intervals.Methods-Data from 16 tumors treated by transarterial chemoembolization with drugeluting beads were successfully obtained. As part of the study, patients provided consent to undergo contrast-enhanced US examinations the morning before embolization, 1 to 2 weeks after embolization, and the morning before follow-up contrast-enhanced magnetic resonance imaging (MRI) or computed tomography (CT) (1 month after embolization). Blinded review of contrast-enhanced US and MRI/CT studies were performed by 2 radiologists who evaluated residual flow as no change, partial change, or no residual flow. Inter-and intra-reader variability rates were calculated before discordant individual reads were settled by consensus.Results-The only adverse event reported during the contrast-enhanced US examinations was a single episode of transient back pain. Contrast-enhanced US at 1 to 2 weeks after embolization (n = 14) resulted in 100% sensitivity, specificity, positive predictive value, negative predictive value, and accuracy. Contrast-enhanced US 1 month after embolization (n = 15) resulted in 75% sensitivity, 100% specificity, 100% positive predictive value, 92% negative predictive value, and 93% accuracy. Inter-reader agreement was 86% for contrast-enhanced US at 1 to 2 weeks, 93% for contrast-enhanced US at 1 month, and 100% for contrast-enhanced MRI/CT at 1 month, whereas intra-reader agreement was 71% for contrast-enhanced US at 1 to 2 weeks, 87% for contrastenhanced US at 1 month, and 91% for MRI/CT.Conclusions-Contrast-enhanced US imaging at 1 to 2 weeks after the procedure may be a viable alternative to MRI/CT for evaluating residual blood flow after transarterial chemoembolization with drug-eluting beads, albeit with a higher degree of reader variability.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Contrast‐Enhanced Ultrasound Evaluation of Residual Blood Flow to Hepatocellular Carcinoma After Treatment With Transarterial Chemoembolization Using Drug‐Eluting Beads

Shaw

Eisenbrey

Lyshchik

et al. 2015

J of Ultrasound Medicine

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“…CE-US with Sonazoid could provide valuable clinical information for planning RFA treatment protocols and was reported to be a useful procedure for assessing the efficacy of RFA of HCC (19). Evaluation of the local recurrence with CE-US is comparable to CE-MDCT which is one of the commonly used modalities for assessing the safety margin after treatment of HCC with RFA (20). Treating the local recurrence is not easy because it is frequently difficult to differentiate between viable tumor and necrotic tissue on conventional US (21).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Contrast-Enhanced Ultrasonography in Radiofrequency Ablation for Hepatocellular Carcinoma

et al. 2012

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Objective Local recurrence after radiofrequency ablation (RFA) is a major problem that needs to resolved to increase the survival rate of hepatocellular carcinoma (HCC). CE-US with Sonazoid , the secondgeneration contrast media, can detect smaller HCC lesions and the detection rate of ultrasonically unrecognized hypervascular HCC was improved by CE-US. The aim of the present study was to evaluate the role of CE-US with Sonazoid in improving radicality and reducing local recurrence after RFA for HCC. Patients and Methods A total of 102 nodules treated by RFA at our hospital from January 2006 to October 2009 were enrolled: 31 nodules were treated without CE-US, since CE-US was not yet available (Group A), and 71 nodules were treated with a combination of RFA and CE-US with Sonazoid (Group B). Results The clinical characteristics (sex, virus marker, Child-Pugh grade, with or without transcatheter arterial infusion chemotherapy with lipiodol, and T factor) did not differ significantly between group A and group B. Mean age was significantly older and tumor size was significantly larger in group B. Group B had significantly better radicality compared with group A. The non-local recurrence rate was significantly higher in group B as compared with group A. Conclusion CE-US with Sonazoid greatly helps to improve RFA efficacy in HCC treatment. We suggest that the ability of CE-US with Sonazoid to detect an accurate area of HCC before RFA and to immediately detect a residual tumor during RFA might contribute to an increase of the radicality and reduction of local recurrence after RFA.

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“…Sonazoid-enhanced US (11,12) was performed in all the patients by two sonographers. The US was carried out with an Aplio XG (Toshiba, Tokyo, Japan) with a micro-convex probe (PVT-375BT, 3.5 MHz; Toshiba).…”

Section: Sonazoid-enhanced Usmentioning

confidence: 99%

“…MatLiver Turk J Gastroenterol 2017;28: 197-201 Evaluation of local tumor residue after percutaneous radiofrequency ablation therapy for hepatocellular carcinoma , a first-generation US contrast agent, improved the localization of sonographically unrecognized hypervascular lesions of the liver (6)(7)(8)(9)(10). Sonazoid ® , a second-generation contrast agent composed of a hard shell containing bubbles, produces stable nonlinear oscillations in the low-power acoustic field and yields enhanced real-time details of the second harmonic signals (11,12).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of local tumor residue after percutaneous radiofrequency ablation therapy for hepatocellular carcinoma

Hamanaka

Goto²,

Nishigori³

et al. 2017

Turk J Gastroenterol

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lesions of 121 hepatocellular carcinoma patients were treated by percutaneous RF ablation, and 22 tumor residues were detected in 22 patients by contrast-enhanced computed tomography. These 22 patients were examined by conventional US, Sonazoidenhanced US (0.5 mL/body of Sonazoid, intravenous administration), and CO 2 -enhanced US (10 mL of CO 2 , hepatic arterial administration). Results: Tumor residue was confirmed by CO 2 -enhanced US in all the 22 patients (sensitivity: 100%) in 19 of the 22 patients by Sonazoid-enhanced US (sensitivity: 86%; 3 lesions that were not detected by this modality were located deeper than the sonographic depth (p=0.0109)), and in 17 of the 22 patients by conventional US (sensitivity: 77%; 5 lesions that were not detected by this modality were smaller in terms of the sonographic tumor size (p=0.0278)). Conclusion: Although CO 2 -enhanced US requires angiography, it was superior to both Sonazoid-enhanced US and conventional US for detecting tumor residues, particularly deep-seated ones, after percutaneous RF ablation.

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Evaluation of local recurrence after treatment for hepatocellular carcinoma by contrast‐enhanced ultrasonography using Sonazoid: Comparison with dynamic computed tomography

Abstract: This study suggests that CEUS using Sonazoid is less affected by the observer's experience and is more accurate in the diagnosis of local recurrence after treatment for HCC than dynamic CT.

Cited by 37 publications

References 31 publications

Contrast‐Enhanced Ultrasound Evaluation of Residual Blood Flow to Hepatocellular Carcinoma After Treatment With Transarterial Chemoembolization Using Drug‐Eluting Beads

Contrast‐Enhanced Ultrasound Evaluation of Residual Blood Flow to Hepatocellular Carcinoma After Treatment With Transarterial Chemoembolization Using Drug‐Eluting Beads

Efficacy of Contrast-Enhanced Ultrasonography in Radiofrequency Ablation for Hepatocellular Carcinoma

Evaluation of local tumor residue after percutaneous radiofrequency ablation therapy for hepatocellular carcinoma

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