Parametric imaging using contrast-enhanced ultrasound with Sonazoid for hepatocellular carcinoma.
OBJECTIVE
To clarify the usefulness of parametric imaging using contrast-enhanced ultrasound (CE-US) with Sonazoid by comparing parametric images of hepatocellular carcinoma (HCC) with histopathological findings.


METHODS
Two patients with HCCs underwent CE-US with Sonazoid before surgical resection. A single focus point was set at the lower margin of the tumor, and a bolus intravenous injection of Sonazoid (0.5 ml) was administered. Images of the ideal scanning plane were displayed in real-time mode for the early vascular phase. We analyzed these images using prototype PC software. The software watches, pixel by pixel, the increase in the intensity due to the inflow of the microbubbles, and displays colors if the intensity becomes larger than a certain threshold. Parametric images were compared with histopathological findings.


RESULTS
The level of blood flow in the tumor could be visually evaluated using a single image by expressing the detailed hemodynamics of the tumor in terms of differences in color using a time axis appropriate for each case.


CONCLUSIONS
Parametric imaging is a very useful way of facilitating straightforward visualization of the level of blood flow within HCC and the distribution of histopathological findings in single static images.
Department of Gastroenterology and Hepatology, Toho University Medical Center, Omori Hospital, 6-11-1, Omorinishi, Ota-ku, Tokyo, 143-8541, Japan. manabu62@med.toho-u.ac.jp.
Manabu
M
Watanabe
Department of Gastroenterology and Hepatology, Toho University Medical Center, Omori Hospital, 6-11-1, Omorinishi, Ota-ku, Tokyo, 143-8541, Japan.
Kazue
K
Shiozawa
Department of Gastroenterology and Hepatology, Toho University Medical Center, Omori Hospital, 6-11-1, Omorinishi, Ota-ku, Tokyo, 143-8541, Japan.
Masayoshi
M
Takahashi
Department of Gastroenterology and Hepatology, Toho University Medical Center, Omori Hospital, 6-11-1, Omorinishi, Ota-ku, Tokyo, 143-8541, Japan.
Noritaka
N
Wakui
Department of Hepato-Biliary-Pancreatic Surgery, Toho University Medical Center, Omori Hospital, 6-11-1, Omorinishi, Ota-ku, Tokyo, 143-8541, Japan.
Yuichiro
Y
Otsuka
Department of Hepato-Biliary-Pancreatic Surgery, Toho University Medical Center, Omori Hospital, 6-11-1, Omorinishi, Ota-ku, Tokyo, 143-8541, Japan.
Hironori
H
Kaneko
Department of Surgical Pathology, Toho University Medical Center, Omori Hospital, 6-11-1, Omorinishi, Ota-ku, Tokyo, 143-8541, Japan.
Kayoko
K
Tanikawa
Department of Surgical Pathology, Toho University Medical Center, Omori Hospital, 6-11-1, Omorinishi, Ota-ku, Tokyo, 143-8541, Japan.
Kazutoshi
K
Shibuya
The Ultrasound Systems Development Department, Toshiba Medical Systems Corporation, Otawara, Tochigi, Japan.
Naohisa
N
Kamiyama
Department of Gastroenterology and Hepatology, Toho University Medical Center, Omori Hospital, 6-11-1, Omorinishi, Ota-ku, Tokyo, 143-8541, Japan.
Yasukiyo
Y
Sumino
Contrast-enhanced ultrasound; Hepatocellular carcinoma; Parametric image; Sonazoid; Time-intensity curve