title: Predictive factors of contrast-enhanced ultrasonography for the response to transarterial chemoembolization in hepatocellular carcinoma.
abstract: OBJECTIVE
  The predictive role of contrast-enhanced ultrasonography (CEUS) before performing transarterial chemoembolization (TACE) has not been determined. We assessed the possible predictive factors of CEUS for the response to TACE.
  
  
  METHODS
  Seventeen patients with 18 hepatocellular carcinoma (HCC) underwent TACE. All of the tumors were studied with CEUS before TACE using a second-generation ultrasound contrast agent (SonoVue®, Bracco, Milan, Italy). The tumor response to TACE was classified with a score between 1 and 4 according to the remaining enhancing-tumor percentage based on modified response evaluation criteria in solid tumors (mRECIST): 1, enhancing tumor <25%; 2, 25%≤enhancing tumor<50%; 3, 50%≤enhancing tumor<75%; and 4, enhancing tumor≥75%). A score of 1 was defined as a "good response" to TACE. The predictive factors for the response to TACE were evaluated during CEUS based on the maximum tumor diameter, initial arterial enhancing time, arterial enhancing duration, intensity of arterial enhancement, presence of a hypoenhanced pattern, and the feeding artery to the tumor.
  
  
  RESULTS
  The median tumor size was 3.1 cm. The distribution of tumor response scores after TACE in all tumors was as follows: 1, n=11; 2, n=4; 3, n=2; and 4, n=1. Fifteen tumors showed feeding arteries. The presence of a feeding artery and the tumor size (≤5 cm) were the predictive factors for a good response (P=0.043 and P=0.047, respectively).
  
  
  CONCLUSIONS
  The presence of a feeding artery and a tumor size of less than 5 cm were the predictive factors for a good response of HCC to TACE on CEUS.
authors.affiliation: Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University Hospital, Seoul, Korea.
authors.forename: Kil Hyo
authors.initials: KH
authors.lastname: Park
authors.affiliation: Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University Hospital, Seoul, Korea.
authors.forename: Soon Ha
authors.initials: SH
authors.lastname: Kwon
authors.affiliation: Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University Hospital, Seoul, Korea.
authors.forename: Yong Sub
authors.initials: YS
authors.lastname: Lee
authors.affiliation: Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University Hospital, Seoul, Korea.
authors.forename: Soung Won
authors.initials: SW
authors.lastname: Jeong
authors.affiliation: Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University Hospital, Seoul, Korea.
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Jang
authors.affiliation: Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University Hospital, Seoul, Korea.
authors.forename: Sae Hwan
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University Hospital, Seoul, Korea.
authors.forename: Sang Gyune
authors.initials: SG
authors.lastname: Kim
authors.affiliation: Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University Hospital, Seoul, Korea.
authors.forename: Sang-Woo
authors.initials: SW
authors.lastname: Cha
authors.affiliation: Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University Hospital, Seoul, Korea.
authors.forename: Young Seok
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University Hospital, Seoul, Korea.
authors.forename: Young Deok
authors.initials: YD
authors.lastname: Cho
authors.affiliation: Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University Hospital, Seoul, Korea.
authors.forename: Hong Soo
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University Hospital, Seoul, Korea.
authors.forename: Boo Sung
authors.initials: BS
authors.lastname: Kim
authors.affiliation: Institute for Digestive Research, Digestive Disease Center, Department of Radiology, Soonchunhyang University Hospital, Seoul, Korea.
authors.forename: Yong Jae
authors.initials: YJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D016461:Chemoembolization, Therapeutic; D003287:Contrast Media / Q000737:chemistry*; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D000903:Antibiotics, Antineoplastic; D003287:Contrast Media; D004317:Doxorubicin
keywords: Contrast-enhanced ultrasonography; Feeding artery; Hepatocellular carcinoma; Transarterial chemoembolization; Tumor size