title: Contrast enhanced ultrasonography in assessing the treatment response to transarterial chemoembolization in patients with hepatocellular carcinoma.
abstract: The last decades have known continuous development of therapeutic strategies in hepatocellular carcinoma (HCC). Unfortunately the disease it still not diagnosed until it is already at an intermediate or even an advanced disease. In these circumstances transarterial chemoembolization (TACE) is considered an effective treatment for HCC. The most important independent prognostic factor of both disease free survival and overall survival is the presence of complete necrosis. Therefore, treatment outcomes are dictated by the proper use of radiological imaging. Current guidelines recommend contrast enhanced computer tomography (CECT) as the standard imaging technique for evaluating the therapeutic response in patients with HCC after TACE. One of the most important disadvantage of CECT is the overestimation of tumor response. As an attempt to overcome this limitation contrast enhanced ultrasound (CEUS) has gained particular attention as an imaging modality in HCC patients after TACE. Of all available imaging modalities, CEUS performs better in the early and very early assessment of TACE especially after lipiodol TACE. As any other imaging techniques CEUS has disadvantages especially in hypovascular tumors or in cases of tumor multiplicity. Not far from now the current limitations of CEUS will be overcome by the new CEUS techniques that are already tested in clinical practice such as dynamic CEUS with quantification, three-dimensional CEUS or fusion techniques.
authors.affiliation: Institute for Gastroenterology and Hepatology,3rd Medical Department, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Zeno
authors.initials: Z
authors.lastname: Sparchez
authors.affiliation: Institute for Gastroenterology and Hepatology, Cluj-Napoca, Romania. mocan_tudor@yahoo.com.
authors.forename: Tudor
authors.initials: T
authors.lastname: Mocan
authors.affiliation: Institute for Gastroenterology and Hepatology, Cluj-Napoca, Romania.
authors.forename: Pompilia
authors.initials: P
authors.lastname: Radu
authors.affiliation: Institute for Gastroenterology and Hepatology, Cluj-Napoca, Romania.
authors.forename: Ofelia
authors.initials: O
authors.lastname: Anton
authors.affiliation: Phoenixswissmed, Basel, Switzerland.
authors.forename: Nicolae
authors.initials: N
authors.lastname: Bolog
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D003287:Contrast Media; D019317:Evidence-Based Medicine; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*; D011379:Prognosis; D016896:Treatment Outcome; D014463:Ultrasonography / Q000379:methods*
chemical_list: D000970:Antineoplastic Agents; D003287:Contrast Media; D006490:Hemostatics