Quantitative Analysis of Contrast-Enhanced Ultrasound in Evaluation of Preoperative Chemotherapy for Wilms Tumor in Children：Pilot Study

Abstract

Background : Contrast enhanced ultrasound (CEUS) has been actively used in the detection of lesions in many organs especially in kidney and liver, but there is no report in evaluation of preoperative chemotherapy for Wilms tumor in children.Methods: 8 children with Wilms tumor were enrolled in this study. All patients accepted preoperative chemotherapy for 4-8 weeks. Each child accepted CEUS examination for 3 times. The image files and the data were analyzed through software. Results: The group included 8 cases with tumor volume from 155.71 to 1624.16 cm3. 6 patients accepted preoperative chemotherapy for 8 weeks before surgery, 2 cases underwent preoperative chemotherapy for 4 weeks. Each child accepted CEUS examination for 3 times and no one showed discomfort to the SonoVue contrast agent. By the comparison from the 3 times CEUS, tumor volume in most of the children was significantly reduced, and the blood perfusion intensity in the tumor was prominently weakened. The results of linear regression showed that the changes of PI between the first and second CEUS examinations and between the second and third CEUS examinations had correlation with the reduction volume of Wilms tumor.Conclusions: It is the first time to apply quantitative analysis of CEUS in evaluation of preoperative chemotherapy for Wilms tumor in children. CEUS is a safe examination in children. CEUS videos could show clearly the changes of tumor perfusion during preoperative chemotherapy. PI can precisely reflect the degree of sensitivity of tumor to chemotherapy in early stage of preoperative chemotherapy.