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Predictive factors of contrast-enhanced ultrasonography for the response to transarterial chemoembolization in hepatocellular carcinoma.

Park KH, Kwon SH, Lee YS, Jeong SW, Jang JY, Lee SH, Kim SG, Cha SW, Kim YS, Cho YD, Kim HS, Kim BS, Kim YJ - Clin Mol Hepatol (2015)

Bottom Line: The predictive role of contrast-enhanced ultrasonography (CEUS) before performing transarterial chemoembolization (TACE) has not been determined.We assessed the possible predictive factors of CEUS for the response to TACE.A score of 1 was defined as a "good response" to TACE.

View Article: PubMed Central - PubMed

Affiliation: Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University Hospital, Seoul, Korea.

ABSTRACT

Background/aims: The predictive role of contrast-enhanced ultrasonography (CEUS) before performing transarterial chemoembolization (TACE) has not been determined. We assessed the possible predictive factors of CEUS for the response to TACE.

Methods: Seventeen patients with 18 hepatocellular carcinoma (HCC) underwent TACE. All of the tumors were studied with CEUS before TACE using a second-generation ultrasound contrast agent (SonoVue®, Bracco, Milan, Italy). The tumor response to TACE was classified with a score between 1 and 4 according to the remaining enhancing-tumor percentage based on modified response evaluation criteria in solid tumors (mRECIST): 1, enhancing tumor <25%; 2, 25%≤enhancing tumor<50%; 3, 50%≤enhancing tumor<75%; and 4, enhancing tumor≥75%). A score of 1 was defined as a "good response" to TACE. The predictive factors for the response to TACE were evaluated during CEUS based on the maximum tumor diameter, initial arterial enhancing time, arterial enhancing duration, intensity of arterial enhancement, presence of a hypoenhanced pattern, and the feeding artery to the tumor.

Results: The median tumor size was 3.1 cm. The distribution of tumor response scores after TACE in all tumors was as follows: 1, n=11; 2, n=4; 3, n=2; and 4, n=1. Fifteen tumors showed feeding arteries. The presence of a feeding artery and the tumor size (≤5 cm) were the predictive factors for a good response (P=0.043 and P=0.047, respectively).

Conclusions: The presence of a feeding artery and a tumor size of less than 5 cm were the predictive factors for a good response of HCC to TACE on CEUS.

No MeSH data available.


Related in: MedlinePlus

A tumor with a score of 1 after TACE. (A) An arrow indicates an enhancing HCC at arterial phase. (B) A tumor after TACE is indicated by an arrow. (C) Two arrows indicate the feeding artery to HCC in arterial phase of CEUS. (D) A compact lipiodol uptake after TACE is indicated by an arrow. TACE, transarterial chemoembolization; HCC, hepatocellular carcinoma; CEUS, contrast-enhanced ultrasonography.
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Figure 1: A tumor with a score of 1 after TACE. (A) An arrow indicates an enhancing HCC at arterial phase. (B) A tumor after TACE is indicated by an arrow. (C) Two arrows indicate the feeding artery to HCC in arterial phase of CEUS. (D) A compact lipiodol uptake after TACE is indicated by an arrow. TACE, transarterial chemoembolization; HCC, hepatocellular carcinoma; CEUS, contrast-enhanced ultrasonography.

Mentions: The demographics such as gender, age of the enrolled patient population and target HCC lesion characteristics such as causes, segmental distribution, mUICC stage, and Child-Pugh score are shown in Table 1. Features of target HCCs according to possible predictors on CEUS before TACE and post-TACE response scores were evaluated on the individual target HCC (Table 2). Median size of tumor was 3.1 cm (range 1.3-14 cm) and median initial arterial enhancing time was 21 seconds. Median arterial enhancing duration was 27.5 seconds and six tumors showed strong arterial enhancement. The presence of hypoenhancement pattern were 14 tumors. Fifteen tumors showed feeding arteries. The number of tumor response score after TACE in all tumors were 11 tumors with score 1, 4 with score 2, 2 with score 3, and 1 with score 4. A tumor with score 1 is noted in Figure 1. In predicting good response after TACE, initial arterial enhancing time, arterial enhancing duration, intensity of arterial enhancement, and hypoenhanced pattern did not show any significance. Presence of a feeding artery and tumor size (≤5 cm) were predictive factors for good response, respectively (P=0.043, P=0.047) (Table 3).


Predictive factors of contrast-enhanced ultrasonography for the response to transarterial chemoembolization in hepatocellular carcinoma.

Park KH, Kwon SH, Lee YS, Jeong SW, Jang JY, Lee SH, Kim SG, Cha SW, Kim YS, Cho YD, Kim HS, Kim BS, Kim YJ - Clin Mol Hepatol (2015)

A tumor with a score of 1 after TACE. (A) An arrow indicates an enhancing HCC at arterial phase. (B) A tumor after TACE is indicated by an arrow. (C) Two arrows indicate the feeding artery to HCC in arterial phase of CEUS. (D) A compact lipiodol uptake after TACE is indicated by an arrow. TACE, transarterial chemoembolization; HCC, hepatocellular carcinoma; CEUS, contrast-enhanced ultrasonography.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4493359&req=5

Figure 1: A tumor with a score of 1 after TACE. (A) An arrow indicates an enhancing HCC at arterial phase. (B) A tumor after TACE is indicated by an arrow. (C) Two arrows indicate the feeding artery to HCC in arterial phase of CEUS. (D) A compact lipiodol uptake after TACE is indicated by an arrow. TACE, transarterial chemoembolization; HCC, hepatocellular carcinoma; CEUS, contrast-enhanced ultrasonography.
Mentions: The demographics such as gender, age of the enrolled patient population and target HCC lesion characteristics such as causes, segmental distribution, mUICC stage, and Child-Pugh score are shown in Table 1. Features of target HCCs according to possible predictors on CEUS before TACE and post-TACE response scores were evaluated on the individual target HCC (Table 2). Median size of tumor was 3.1 cm (range 1.3-14 cm) and median initial arterial enhancing time was 21 seconds. Median arterial enhancing duration was 27.5 seconds and six tumors showed strong arterial enhancement. The presence of hypoenhancement pattern were 14 tumors. Fifteen tumors showed feeding arteries. The number of tumor response score after TACE in all tumors were 11 tumors with score 1, 4 with score 2, 2 with score 3, and 1 with score 4. A tumor with score 1 is noted in Figure 1. In predicting good response after TACE, initial arterial enhancing time, arterial enhancing duration, intensity of arterial enhancement, and hypoenhanced pattern did not show any significance. Presence of a feeding artery and tumor size (≤5 cm) were predictive factors for good response, respectively (P=0.043, P=0.047) (Table 3).

Bottom Line: The predictive role of contrast-enhanced ultrasonography (CEUS) before performing transarterial chemoembolization (TACE) has not been determined.We assessed the possible predictive factors of CEUS for the response to TACE.A score of 1 was defined as a "good response" to TACE.

View Article: PubMed Central - PubMed

Affiliation: Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University Hospital, Seoul, Korea.

ABSTRACT

Background/aims: The predictive role of contrast-enhanced ultrasonography (CEUS) before performing transarterial chemoembolization (TACE) has not been determined. We assessed the possible predictive factors of CEUS for the response to TACE.

Methods: Seventeen patients with 18 hepatocellular carcinoma (HCC) underwent TACE. All of the tumors were studied with CEUS before TACE using a second-generation ultrasound contrast agent (SonoVue®, Bracco, Milan, Italy). The tumor response to TACE was classified with a score between 1 and 4 according to the remaining enhancing-tumor percentage based on modified response evaluation criteria in solid tumors (mRECIST): 1, enhancing tumor <25%; 2, 25%≤enhancing tumor<50%; 3, 50%≤enhancing tumor<75%; and 4, enhancing tumor≥75%). A score of 1 was defined as a "good response" to TACE. The predictive factors for the response to TACE were evaluated during CEUS based on the maximum tumor diameter, initial arterial enhancing time, arterial enhancing duration, intensity of arterial enhancement, presence of a hypoenhanced pattern, and the feeding artery to the tumor.

Results: The median tumor size was 3.1 cm. The distribution of tumor response scores after TACE in all tumors was as follows: 1, n=11; 2, n=4; 3, n=2; and 4, n=1. Fifteen tumors showed feeding arteries. The presence of a feeding artery and the tumor size (≤5 cm) were the predictive factors for a good response (P=0.043 and P=0.047, respectively).

Conclusions: The presence of a feeding artery and a tumor size of less than 5 cm were the predictive factors for a good response of HCC to TACE on CEUS.

No MeSH data available.


Related in: MedlinePlus