title: Intra-arterial contrast-enhanced ultrasound (IA CEUS) for localization of hepatocellular carcinoma (HCC) supply during transarterial chemoembolization (TACE): a case series.
abstract: Transarterial chemoembolization (TACE) is a proven catheter-based locoregional therapy for treatment of hepatocellular carcinoma (HCC). Drug-eluting bead TACE involves delivering micrometer-sized particles preloaded with doxorubicin directly to the tumor via its arterial blood supply and results in vascular embolization with intra-tumoral drug release. Effective therapy requires mapping of the tumor arterial supply, which in some cases cannot be accomplished with conventional angiographic techniques alone. Contrast-enhanced ultrasound (CEUS) is an imaging technique which utilizes microbubble contrast agents to demonstrate blood flow and tissue perfusion, enabling tumor visualization in real time. CEUS with intravenous contrast administration is well established for evaluation of HCC. Intra-arterial (IA) CEUS, on the other hand, is an emerging technique that allows more selective evaluation of the arterial supply to the tumor. The three cases in this report illustrate the utility of intra-procedural IA CEUS during TACE. Specifically, IA CEUS aided TACE in cases where the HCC showed poor arterial enhancement, an extrahepatic arterial supply, and a portal venous supply, respectively.
authors.affiliation: Department of Radiology, Keck School of Medicine of the University of Southern California, 1500 San Pablo Street, 2nd Floor Imaging, Los Angeles, CA, 90033, USA.
authors.forename: Ilya
authors.initials: I
authors.lastname: Lekht
authors.affiliation: Department of Radiology, Keck School of Medicine of the University of Southern California, 1500 San Pablo Street, 2nd Floor Imaging, Los Angeles, CA, 90033, USA.
authors.forename: Megha
authors.initials: M
authors.lastname: Nayyar
authors.affiliation: Department of Radiology, Keck School of Medicine of the University of Southern California, 1500 San Pablo Street, 2nd Floor Imaging, Los Angeles, CA, 90033, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Luu
authors.affiliation: Department of Radiology, Keck School of Medicine of the University of Southern California, 1500 San Pablo Street, 2nd Floor Imaging, Los Angeles, CA, 90033, USA. guichet@usc.edu.
authors.forename: Phillip L
authors.initials: PL
authors.lastname: Guichet
authors.affiliation: Department of Radiology, Keck School of Medicine of the University of Southern California, 1500 San Pablo Street, 2nd Floor Imaging, Los Angeles, CA, 90033, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Ho
authors.affiliation: Department of Radiology, Keck School of Medicine of the University of Southern California, 1500 San Pablo Street, 2nd Floor Imaging, Los Angeles, CA, 90033, USA.
authors.forename: Ramon
authors.initials: R
authors.lastname: Ter-Oganesyan
authors.affiliation: Department of Radiology, Keck School of Medicine of the University of Southern California, 1500 San Pablo Street, 2nd Floor Imaging, Los Angeles, CA, 90033, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Katz
authors.affiliation: Department of Radiology, Keck School of Medicine of the University of Southern California, 1500 San Pablo Street, 2nd Floor Imaging, Los Angeles, CA, 90033, USA.
authors.forename: Mittul
authors.initials: M
authors.lastname: Gulati
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000628:therapy* / Q000821:virology; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D003287:Contrast Media; D019698:Hepatitis C, Chronic / Q000150:complications; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy* / Q000821:virology; D008297:Male; D008875:Middle Aged; D014463:Ultrasonography / Q000379:methods*
chemical_list: D003287:Contrast Media
keywords: Contrast-enhanced ultrasound; Hepatocellular carcinoma; Intra-arterial contrast-enhanced ultrasound; Transarterial chemoembolization