Short-term evaluation of liver tumors after transarterial chemoembolization: limitations and feasibility of contrast-enhanced ultrasonography.
OBJECTIVE
To evaluate the limitations and the feasibility of contrast-enhanced ultrasonography (CEUS) for the assessment of tumor response shortly after transarterial chemoembolization (TACE).


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).


CONCLUSIONS
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.
Department of Radiology, General Hospital Tzanio, Zanni & Afentouli 1 str, 18536, Piraeus, Greece. hipmosch@gmail.com
Hippocrates
H
Moschouris
Katerina
K
Malagari
Marina Georgiou
MG
Papadaki
Ioannis
I
Kornezos
Panagiotis
P
Gkoutzios
Nikolaos
N
Tepelenis
Dimitrios
D
Matsaidonis
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D003287:Contrast Media; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010743:Phospholipids; D012189:Retrospective Studies; D013459:Sulfur Hexafluoride; D016896:Treatment Outcome; D014463:Ultrasonography
D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride