title: Degradable starch microspheres transarterial chemoembolisation (DSM-TACE) of HCC: Dynamic Contrast-Enhanced Ultrasonography (DCE-US) based evaluation of therapeutic efficacy using a novel perfusion software.
abstract: OBJECTIVE
  To evaluate therapeutic efficacy of degradable starch microsphere (DSM)-TACE in hepatocellular carcinoma (HCC) using Dynamic Contrast-Enhanced Ultrasonography (DCE-US) based perfusion analysis.
  
  
  METHODS
  A total of 60 DCE-US examinations were performed in 15 selected patients who underwent DSM-TACE with EmboCept®S for the treatment of advanced HCC. DCE-US was performed via i.v. application of ultrasound contrast media before and 24 hours post embolization. In addition DCE-US was performed with i.a. contrast application via the angiographic catheter right before and after the embolization. Microcirculation of embolized HCC lesions was quantified using a dedicated perfusion software by two experienced radiologists in consensus.
  
  
  RESULTS
  Significant reduction of microvascularization (PE, WiAUC and WiR) was seen right after DSM-TACE and during 24 hour follow-up. Mean PE was 342.22 ± 97.80 prior to embolization, 59.28 ± 29.74 post embolization (p = 0.019) and 18.83 ± 7.03 during follow-up (p ≤ 0.01). Mean WiAUC was 1103.21 ± 432.05 prior to embolization 267.69 ± 151.80 post embolization (p = 0.023) and 105.10 ± 44.43 during 24 hour follow-up (p ≤ 0.01). The corresponding values for WiR were 224.91 ± 57.97 prior-, 38.14 ± 18.80 post embolization (p = 0.034) and 6.97 ± 2.68 during follow up (p ≤ 0.01).
  
  
  CONCLUSIONS
  In this study, therapeutic efficacy of DSM-TACE in HCC using DCE-US based perfusion analysis could be demonstrated.
authors.affiliation: Department of Radiology, University Medical Center Regensburg, Regensburg, Germany. philipp.wiggermann@klinik.uni-regensburg.de
authors.forename: P
authors.initials: P
authors.lastname: Wiggermann
authors.forename: M
authors.initials: M
authors.lastname: Heibl
authors.forename: C
authors.initials: C
authors.lastname: Niessen
authors.forename: R
authors.initials: R
authors.lastname: Müller-Wille
authors.forename: H
authors.initials: H
authors.lastname: Gössmann
authors.forename: W
authors.initials: W
authors.lastname: Uller
authors.forename: F
authors.initials: F
authors.lastname: Poschenrieder
authors.forename: A G
authors.initials: AG
authors.lastname: Schreyer
authors.forename: W A
authors.initials: WA
authors.lastname: Wohlgemuth
authors.forename: C
authors.initials: C
authors.lastname: Stroszczynski
authors.forename: E M
authors.initials: EM
authors.lastname: Jung
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D003287:Contrast Media; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012984:Software; D013213:Starch / Q000008:administration & dosage*; D014463:Ultrasonography / Q000379:methods
chemical_list: D003287:Contrast Media; C083286:degradable starch microspheres; D013213:Starch