@article{2986314,
    title = "Short-term evaluation of liver tumors after transarterial chemoembolization: Limitations and feasibility of contrast-enhanced ultrasonography",
    author = "Moschouris, H. and Malagari, K. and Papadaki, M.G. and Kornezos, I. and Gkoutzios, P. and Tepelenis, N. and Matsaidonis, D.",
    journal = "Abdominal Imaging",
    year = "2011",
    volume = "36",
    number = "6",
    pages = "718-728",
    issn = "0942-8925, 1432-0509",
    doi = "10.1007/s00261-011-9690-4",
    keywords = "doxorubicin, adult;  aged;  article;  chemoembolization;  computer assisted tomography;  contrast enhancement;  echography;  female;  human;  liver cell carcinoma;  liver metastasis;  major clinical study;  male;  nuclear magnetic resonance imaging;  priority journal;  tumor growth, Adult;  Aged;  Aged, 80 and over;  Chemoembolization, Therapeutic;  Contrast Media;  Feasibility Studies;  Female;  Humans;  Liver Neoplasms;  Male;  Middle Aged;  Phospholipids;  Retrospective Studies;  Sulfur Hexafluoride;  Treatment Outcome",
    abstract = "Purpose: To evaluate the limitations and the feasibility of contrast-enhanced ultrasonography (CEUS) for the assessment of tumor response shortly after transarterial chemoembolization (TACE). Materials and methods: Fifty seven patients (41 patients with hepatomas, 16 patients with metastases) were studied with CEUS before, 1 day after, and 30 days after TACE. A CEUS-efficiency score (CEUS-ES) was calculated, which evaluated: (a) the completeness of visualization of the target tumor(s) (2: good, 1: adequate, 0: poor) and (b) the quality of delineation of post-TACE necroses (2: good, 1: adequate, 0: poor). A CEUS study was considered as "diagnostic," if each of the aforementioned parameters was associated with grade 1 or 2. Results: CEUS studies were "diagnostic" in 36/57 patients (63.1%). Patients with hepatomas were more likely to undergo "diagnostic" CEUS than patients with metastases (70.7% vs. 43.7%, P = 0.0728). Lesions' multiplicity, deep location, hypoenhancement on pretreatment CEUS, and diffuse growth had a statistically significant (P < 0.05) negative impact on CEUS-ES. Hyperechogenicity on pre-treatment, unenhanced US had a non-statistically significant (P = 0.176) negative impact. Differences between "diagnostic" CEUS studies and CT/MR regarding detection of residual tumor were insignificant (P = 0.8178). Conclusion: The percentage of lesions which are unsuitable for post-TACE evaluation with CEUS is not negligible. For the rest, the respective role of CEUS is promising. © 2011 Springer Science+Business Media, LLC."
}