title: Use of contrast-enhanced ultrasonography with a perflubutane-based contrast agent performed one day after transarterial chemoembolization for the early assessment of residual viable hepatocellular carcinoma.
abstract: OBJECTIVE
  We evaluated the efficacy of contrast-enhanced ultrasonography (US), compared with contrast-enhanced computed tomography (CT), for early assessments after transarterial chemoembolization (TACE) for the treatment of hypervascular hepatocellular carcinoma (HCC) lesions.
  
  
  METHODS
  Thirty-two patients with 59 HCC lesions who were scheduled to receive TACE were enrolled in this prospective study. TACE was performed by injecting a mixture of iodized oil and miriplatin hydrate, followed by a gelatin sponge. Digital subtraction angiography (DSA) and/or contrast-enhanced CT were performed 2-6 months after TACE and were used as the reference standard for residual HCC; the detection rates for residual viable HCC using contrast-enhanced US with a perflubutane-based contrast agent and a high mechanical index (MI) mode performed one day after TACE were also compared with those obtained using contrast-enhanced CT performed one month after TACE. The comparisons were made using the McNemar test.
  
  
  RESULTS
  Forty-seven (79.7%) of the 59 HCC lesions were diagnosed as having residual viability based on DSA and contrast-enhanced CT findings obtained 2-6 months after TACE. Eight (17.0%) of the 47 HCC lesions that were diagnosed as having residual viability using one-day contrast-enhanced US were not detected using one-month contrast-enhanced CT because of artifacts produced by the high attenuation of the iodized oil. The detection rate for residual HCC lesions using one-day contrast-enhanced US (95.7%, 45/47) was significantly higher than that using one-month contrast-enhanced CT (78.7%, 37/47) (P<0.05).
  
  
  CONCLUSIONS
  Contrast-enhanced US performed one day after TACE is more sensitive than contrast-enhanced CT performed one month after TACE for detecting residual viable HCC.
authors.affiliation: Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa 232-0024, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Takizawa
authors.forename: Kazushi
authors.initials: K
authors.lastname: Numata
authors.forename: Manabu
authors.initials: M
authors.lastname: Morimoto
authors.forename: Masaaki
authors.initials: M
authors.lastname: Kondo
authors.forename: Akito
authors.initials: A
authors.lastname: Nozaki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Moriya
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Ishii
authors.forename: Takashi
authors.initials: T
authors.lastname: Oshima
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Fukuda
authors.forename: Masahiro
authors.initials: M
authors.lastname: Okada
authors.forename: Shigeo
authors.initials: S
authors.lastname: Takebayashi
authors.forename: Shin
authors.initials: S
authors.lastname: Maeda
authors.forename: Katsuaki
authors.initials: K
authors.lastname: Tanaka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D003287:Contrast Media; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007479:Iopamidol; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D009944:Organoplatinum Compounds / Q000627:therapeutic use*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D000970:Antineoplastic Agents; D003287:Contrast Media; D009944:Organoplatinum Compounds; C406530:miriplatin; D007479:Iopamidol
keywords: Contrast-enhanced ultrasonography; Hepatocellular carcinoma; Transarterial chemoembolization