title: Hepatocellular carcinoma: therapeutic experience with percutaneous ethanol injection under real-time contrast-enhanced color Doppler sonography with the contrast agent Levovist.
abstract: OBJECTIVE
  To describe our experience with percutaneous ethanol injection under real-time contrast-enhanced color Doppler sonography with Levovist (SH U 508A; Nihon Schering, Osaka, Japan) for hepatocellular carcinoma after transcatheter arterial infusion.
  
  
  METHODS
  Twenty patients (17 men and 3 women; mean age, 58.4 years) with 23 hepatocellular carcinoma nodules (mean +/- SD, 2.7 +/- 1.5 cm) underwent percutaneous ethanol injection under real-time contrast-enhanced color Doppler sonography 1 week after transcatheter arterial infusion. Therapeutic effects were assessed by contrast-enhanced computed tomography and posttreatment fine-needle biopsy. This study was performed on a prospective basis.
  
  
  RESULTS
  After the transcatheter arterial infusion, contrast-enhanced color Doppler sonography showed intense intratumoral color signals in all 23 hepatocellular carcinomas. After the percutaneous ethanol injection, contrast-enhanced color Doppler sonography, fine-needle biopsy, and contrast-enhanced computed tomography showed no color signals, no viable tumor tissues, and no enhancement in any of the 23 hepatocellular carcinomas. Three to 5 (mean, 3.3) percutaneous ethanol injection sessions with a 5.2- to 15.6-mL (mean, 12.8-mL) total volume of ethanol per tumor were required for complete disappearance of color signals on contrast-enhanced color Doppler sonography.
  
  
  CONCLUSIONS
  Percutaneous ethanol injection under real-time contrast-enhanced color Doppler sonography has considerable efficacy in treating hepatocellular carcinoma.
authors.affiliation: Gastroenterological Center, Yokohama City University Medical Center, Japan.
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Shirato
authors.forename: Manabu
authors.initials: M
authors.lastname: Morimoto
authors.forename: Naohiko
authors.initials: N
authors.lastname: Tomita
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kokawa
authors.forename: Kazuya
authors.initials: K
authors.lastname: Sugimori
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Saito
authors.forename: Kazushi
authors.initials: K
authors.lastname: Numata
authors.forename: Hisahiko
authors.initials: H
authors.lastname: Sekihara
authors.forename: Katsuaki
authors.initials: K
authors.lastname: Tanaka
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D003287:Contrast Media; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007089:Image Enhancement; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011134:Polysaccharides; D011446:Prospective Studies; D018615:Ultrasonography, Doppler, Color
chemical_list: D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508; D000431:Ethanol