title: Pilot study evaluating catheter-directed contrast-enhanced ultrasound compared to catheter-directed computed tomography arteriography as adjuncts to digital subtraction angiography to guide transarterial chemoembolization.
abstract: OBJECTIVE
  To investigate the feasibility and procedural value of catheter-directed contrast-enhanced ultrasound (CCEUS) compared with catheter-directed computed tomography arteriography (CCTA) in patients undergoing transarterial chemoembolization (TACE) guided by digital subtraction angiography (DSA).
  
  
  METHODS
  From December 2010 to December 2011, a pilot study was conducted including nine patients (mean age 66.6 years; SD 8.3 years; seven men) undergoing TACE with drug-eluting beads for unresectable hepatocellular carcinoma (HCC). Both CCEUS and CCTA were performed in addition to DSA. Alterations of treatment plan based on CCEUS were recorded and compared with CCTA.
  
  
  RESULTS
  CCEUS provided additional information to DSA altering the treatment plan in four out of nine patients (44.4%). In these four patients, CCEUS helped to identify additional tumour feeders (n = 2) or led to a change in catheter position (n = 2). The information provided by CCEUS was similar to that provided by CCTA.
  
  
  CONCLUSIONS
  CCEUS is a potentially valuable imaging tool in adjunction to DSA when performing TACE and may provide similar information to CCTA.
authors.affiliation: Interventional Radiology Center, Department of Diagnostic Radiology, Singapore General Hospital, Singapore; Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: mburgmans@hotmail.com.
authors.forename: M C
authors.initials: MC
authors.lastname: Burgmans
authors.affiliation: Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: A R
authors.initials: AR
authors.lastname: van Erkel
authors.affiliation: Interventional Radiology Center, Department of Diagnostic Radiology, Singapore General Hospital, Singapore.
authors.forename: C W
authors.initials: CW
authors.lastname: Too
authors.affiliation: Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Coenraad
authors.affiliation: Interventional Radiology Center, Department of Diagnostic Radiology, Singapore General Hospital, Singapore.
authors.forename: R H G
authors.initials: RH
authors.lastname: Lo
authors.affiliation: Interventional Radiology Center, Department of Diagnostic Radiology, Singapore General Hospital, Singapore.
authors.forename: B S
authors.initials: BS
authors.lastname: Tan
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction / Q000379:methods*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy; D057785:Catheters; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D003287:Contrast Media; D005240:Feasibility Studies; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007472:Iohexol; D008113:Liver Neoplasms / Q000188:drug therapy; D008297:Male; D045423:Microbubbles; D008875:Middle Aged; D010743:Phospholipids; D010865:Pilot Projects; D015641:Radiography, Interventional / Q000295:instrumentation / Q000379:methods; D013459:Sulfur Hexafluoride; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods*; D018084:Ultrasonography, Interventional / Q000295:instrumentation / Q000379:methods
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D007472:Iohexol; D013459:Sulfur Hexafluoride