title: Contrast-enhanced ultrasonography with intraarterial administration of SonoVue for guidance of transarterial chemoembolization: an initial experience.
abstract: OBJECTIVE
  To describe the technique and to evaluate the feasibility of contrast-enhanced ultrasound with intraarterial administration of echo-enhancer (i.a CEUS) as a method for guidance of transarterial chemoembolization (TACE).
  
  
  METHODS
  Twelve patients with 17 target liver tumors underwent superselective TACE, guided with i.a CEUS. After microcatheter placement in a (sub)segmental artery suspected as a tumor feeder, a diluted suspension of SonoVue was injected through the microcatheter, and imaging of the target tumor was performed with a low mechanical index technique and with contrast-specific software. If intraarterial injection of SonoVue was associated with immediate, strong tumoral enhancement, the injected artery was considered as tumor-feeding and TACE was performed, otherwise another artery was evaluated.
  
  
  RESULTS
  From 25 segmental or subsegmental arteries evaluated i.a CEUS confirmed that 16 arteries were actually tumor feeders and unequivocal excluding  4 arteries as a tumor arterial supply. The remainder 5 arterial branches could not be safely characterized due to artifacts or technical limitations. In 8 patients in which tumoral vascular supply could not be elucidated by angiography alone, i.a CEUS increased the accuracy of supereselective embolization, and provided other clinically relevant information in 2 of these patients. No adverse effects were observed.
  
  
  CONCLUSIONS
  For guidance of superselective TACE i.a CEUS is a safe and feasible method..
authors: Department of Radiology, General Hospital Tzanio, Piraeus, Greece. motogna@hotmail.com
authors: Hippocrates
authors: H
authors: Moschouris
authors: Katerina
authors: K
authors: Malagari
authors: Marianna
authors: M
authors: Kalokairinou
authors: Konstantinos
authors: K
authors: Stamatiou
authors: Athanasios
authors: A
authors: Marinis
authors: Marina Georgiou
authors: MG
authors: Papadaki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D018281:Cholangiocarcinoma / Q000000981:diagnostic imaging / Q000628:therapy*; D003287:Contrast Media / Q000008:administration & dosage*; D004317:Doxorubicin / Q000008:administration & dosage; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007269:Injections, Intra-Arterial; D000077146:Irinotecan; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000628:therapy*; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D010743:Phospholipids / Q000008:administration & dosage*; D011446:Prospective Studies; D013459:Sulfur Hexafluoride / Q000008:administration & dosage*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods*
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D000077146:Irinotecan; D004317:Doxorubicin; D013459:Sulfur Hexafluoride; D002166:Camptothecin