Clin Mol Hepatol.  2015 Jun;21(2):158-164. 10.3350/cmh.2015.21.2.158.

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

• KMID: 2164366
• DOI: http://doi.org/10.3350/cmh.2015.21.2.158

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(R), 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%< or =enhancing tumor<50%; 3, 50%< or =enhancing tumor<75%; and 4, enhancing tumor> or =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 (< or =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.

Keyword

Transarterial chemoembolization; Contrast-enhanced ultrasonography; Hepatocellular carcinoma; Tumor size; Feeding artery

MeSH Terms

Adult
Aged
Aged, 80 and over
Antibiotics, Antineoplastic/administration & dosage
Carcinoma, Hepatocellular/pathology/therapy/*ultrasonography
Chemoembolization, Therapeutic
Contrast Media/*chemistry
Doxorubicin/administration & dosage
Female
Humans
Liver Neoplasms/pathology/therapy/*ultrasonography
Male
Microspheres
Middle Aged
Tomography, X-Ray Computed
Treatment Outcome
Antibiotics, Antineoplastic
Contrast Media
Doxorubicin