Monitoring of hepatocellular carcinoma, following proton radiotherapy, with contrast-enhanced color Doppler ultrasonography

Abstract

We propose CECDU as a useful diagnostic option for the evaluation of HCC treated with proton radiotherapy.

Post‐therapeutic needle biopsy in patients with hepatocellular carcinoma is a useful tool to evaluate response to proton irradiation

“…Furthermore, hypervascularity is not always a characteristic feature of undamaged HCC because an increase in blood flow in the nodule (due to radiation‐induced liver injury) is often observed during the early post‐irradiated period . We previously studied tumor blood flow using CECDU and reported that a transient increase in tumor blood flow was also recognized by this method in more than half of the patients immediately after proton therapy …”

“…10,[20][21][22] We previously studied tumor blood flow using CECDU and reported that a transient increase in tumor blood flow was also recognized by this method in more than half of the patients immediately after proton therapy. 13 Because of the insufficient diagnosability using CT and CECDU for the degeneration of HCC during the early post-irradiated period, percutaneous fine-needle aspiration biopsy was performed. Taking HCC biopsies is not generally recommended because there is the possibility of the tumor seeding outside of the liver.…”

“…Computed tomography (CT), magnetic resonance imaging and contrast‐enhanced color Doppler ultrasonography (CECDU) are all useful methods to evaluate the therapeutic response of HCC after proton irradiation. However, these imaging methods are not accurate during the early post‐irradiated period because the reduction in tumor size or reduced blood flow in the tumor are not clear during this period using these techniques …”

“…However, these imaging methods are not accurate during the early postirradiated period because the reduction in tumor size or reduced blood flow in the tumor are not clear during this period using these techniques. 13 MIB-1 is an anti-Ki-67 monoclonal antibody developed by Cattoretti et al, and it is used for the easy and accurate evaluation of cell proliferation potential in formalin-fixed paraffin-embedded tissues using an antigen retrieval technique. 14,15 We previously reported that the MIB-1 labeling indices of HCC samples obtained using ultrasound-guided, fine-needle liver biopsies were significantly correlated with tumor volume doubling times and were better indicators of tumor aggressiveness than the conventional indices of histological atypia.…”

Therapeutic Evaluation of Radiotherapy with Contrast-Enhanced Ultrasound in Non-Resectable Hepatocellular Carcinoma Patients with Portal Vein Tumor Thrombosis

“…In addition, CEUS can be quantitatively analyzed for clinicians. CEUS has already been successfully used in monitoring anti-angiogenic therapies for tumors [ 19 , 20 ] and assessments before and after radiotherapy of HCC [ 21 , 22 ]. However, therapeutic evaluation of 3DCRT has been rarely reported for non-resectable HCC with PVTT.…”