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

Abstract

BackgroundTherapeutic evaluation of 3-dimensional conformal radiotherapy (3DCRT) is rarely reported for non-resectable hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT). The aim of this study was to determine the value of contrast-enhanced ultrasound (CEUS) in evaluating the therapeutic response of HCC with PVTT treated with 3DCRT.Material/MethodsPVTT reduction rate in the study was determined after 3DCRT using time intensity curve (TIC) analysis software before and after radiotherapy. Seventy-nine HCC patients with PVTT treated with 3DCRT were studied. HCC and PVTT were performed by CEUS, before and after 3DCRT, over time. The parameters of blood flow, including arrival time (AT), time to peak (TTP), peak intensity (PI), washout time (WT), and area under the curve (AUC), were quantified and evaluated on still images by CEUS.ResultsAfter 3DCRT, typing and staging of PVTT in 38 patients was decreased, the reduction rate was 48.1%. HCC was effective in 45 patients, the effective rate was 57%; No differences were found between the PVTT reduction rate and the HCC effective rate (χ2=2.96, P>0.05). In the effective group, the PI and AUC of HCCs and PVTTs after 3DCRT were significantly lower than before 3DCRT, while the other parameters of TIC were not significantly different before and after 3DCRT.ConclusionsCEUS might be a useful monitoring option for the evaluation of HCC with PVTT treated with 3DCRT. CEUS might be useful as an important choice for monitoring and evaluation HCC with PVTT after 3DCRT. TIC parameters might provide quantitative data for efficacy evaluation, which helps to modify treatment strategies timely and accurately.

Clinical application of spectral CT perfusion scanning in evaluating the blood supply source of portal vein tumor thrombus in hepatocellular carcinoma

“…There was no statistically significant difference in mean values between the remaining items. PVTT might obstruct the portal vein blood flow of the tumor ( 17 ) and the corresponding segment of liver parenchyma to influence perfusion parameters. Nevertheless, the blood supply of the distal PVTT was less affected by the main portal vein, so the values of IC and spectral slope from the distal PVTT were similar.…”

Ultrasound irradiation inhibits proliferation of cervical cancer cells by initiating endoplasmic reticulum stress-mediated apoptosis and triggering phosphorylation of JNK

“…Although USI could induce apoptosis in both cancer cells and normal cells, the cancer cells are more sensitive to the treatment and more easily killed compared to normal cells. 18,19 Meanwhile, Lagneaux et al 20 reported that cancer cells are more susceptible to the USI due to higher cell apoptotic rates. Therefore, USI that can cause apoptosis might be of clinical importance as a novel therapeutic approach.…”