TY - JOUR
TI - Unenhanced and contrast-enhanced ultrasonography during hepatic transarterial embolization and chemoembolization with drug-eluting beads
AU - Moschouris, H.
AU - Malagari, K.
AU - Kornezos, I.
AU - Papadaki, M.G.
AU - Gkoutzios, P.
AU - Matsaidonis, D.
JO - CardioVascular and Interventional Radiology
PY - 2010
VL - 33
TODO - 6
SP - 1215-1222
PB - 
SN - 0174-1551, 1432-086X
TODO - 10.1007/s00270-010-9918-7
TODO - doxorubicin;  irinotecan;  microsphere;  sonovue, adult;  aged;  article;  artificial embolism;  chemoembolization;  clinical article;  computer assisted tomography;  contrast enhancement;  controlled study;  devascularization;  drug delivery system;  drug eluting bead;  echography;  female;  hepatic artery embolization;  human;  intermethod comparison;  liver angiography;  liver cell carcinoma;  liver hemangioma;  liver metastasis;  male;  nuclear magnetic resonance imaging;  patient monitoring;  priority journal;  tumor necrosis, Adult;  Aged;  Angiography;  Antineoplastic Agents;  Chemoembolization, Therapeutic;  Contrast Media;  Embolization, Therapeutic;  Female;  Humans;  Liver Neoplasms;  Male;  Microspheres;  Middle Aged;  Phospholipids;  Sulfur Hexafluoride;  Treatment Outcome;  Ultrasonography, Interventional
TODO - The purpose of this study was to describe and evaluate the findings of unenhanced ultrasonography (US) and contrast-enhanced ultrasonography (CEUS) when these modalities are applied during transarterial embolization (TAE) or transarterial chemoembolization (TACE) of liver tumors. Sixteen tumors (9 hepatocellular carcinomas, 5 metastases from colorectal cancer, and 2 hemangiomas) were treated with TAE with microspheres and/or TACE with drug-eluting beads. All of these lesions were studied with intraprocedural unenhanced US and 12 were studied with intraprocedural CEUS. For the latter, a second-generation echo-enhancer (SonoVue; Bracco, Milan, Italy) and a low mechanical index technique were used. Intraprocedural findings were classified according to an arbitrary scale and were compared with pretreatment imaging (CEUS and computed tomography or CEUS and magnetic resonance imaging), with postembolization angiography, and with follow-up results. On unenhanced intraprocedural US, 13 of 16 tumors demonstrated intralesional high-level echoes of varying extent. These feature correlated poorly (r = 0.33, p = 0.097) with and generally underestimated the actual extent of necrosis. Exceptionally, high-level echoes that occupied the largest part of the treated lesions were associated with >50% tumor necrosis. Intraprocedural CEUS clearly depicted immediate partial or complete disappearance of tumor enhancement as a result of TAE/TACE. Three of 6 tumors with complete devascularization on postembolization angiogram showed residual enhancement on intraprocedural CEUS. Intraprocedural CEUS findings correlated closely (r = 0.91, p = 0.002) with follow-up findings. Intraprocedural sonography, particularly with echo-enhancers, could be used for intraprocedural monitoring in selected cases of liver tumors that undergo TAE or TACE. © 2010 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).
ER -