Contrast-Enhanced Ultrasonography of Hepatocellular Carcinoma After Chemoembolisation Using Drug-Eluting Beads: A Pilot Study Focused on Sustained Tumor Necrosis
The purpose of this study was to assess the use of contrast-enhanced ultrasonography (CEUS) and the sustained antitumor effect of drug-eluting beads used for transarterial chemoembolisation (TACE) of unresectable hepatocellular carcinoma (HCC). Ten patients with solitary, unresectable HCC underwent...
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| Veröffentlicht in: | Cardiovascular and interventional radiology 2010-10, Vol.33 (5), p.1022-1027 |
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| creator | Moschouris, Hippocrates Malagari, Katerina Papadaki, Marina Georgiou Kornezos, Ioannis Matsaidonis, Dimitrios |
| description | The purpose of this study was to assess the use of contrast-enhanced ultrasonography (CEUS) and the sustained antitumor effect of drug-eluting beads used for transarterial chemoembolisation (TACE) of unresectable hepatocellular carcinoma (HCC). Ten patients with solitary, unresectable HCC underwent CEUS before, 2 days after, and 35 to 40 days after TACE using a standard dose (4 ml) of drug-eluting beads (DC Beads; Biocompatibles, Surrey, UK) preloaded with doxorubicin (25 mg doxorubicin/ml hydrated beads). For CEUS, a second-generation contrast agent (SonoVue, Bracco, Milan, Italy) and a low mechanical–index technique were used. A part of the tumor was characterized as necrotic if it showed complete lack of enhancement. The percentage of necrosis was calculated at the sonographic section that depicted the largest diameter of the tumor. Differences in the extent of early (2 days after TACE) and delayed (35 to 40 days after TACE) necrosis were quantitatively and subjectively assessed. Early post-TACE tumor necrosis ranged from 21% to 70% (mean 43.5% ± 19%). There was a statistically significant (
p
= 0.0012, paired Student
t
test) higher percentage of delayed tumor necrosis, which ranged from 24% to 88% (mean 52.3% ± 20.3%). Subjective evaluation showed a delayed obvious increase of the necrotic areas in 5 patients. In 2 patients, tumor vessels that initially remained patent disappeared on the delayed follow-up. A part of tumor necrosis after chemoembolisation of HCC with DEB seems to take place later than 2 days after TACE. CEUS may provide evidence for the sustained antitumor effect of DEB-TACE. Nevertheless, the ideal time for the imaging evaluation of tumor response remains to be defined. |
| doi_str_mv | 10.1007/s00270-010-9800-7 |
| format | Article |
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p
= 0.0012, paired Student
t
test) higher percentage of delayed tumor necrosis, which ranged from 24% to 88% (mean 52.3% ± 20.3%). Subjective evaluation showed a delayed obvious increase of the necrotic areas in 5 patients. In 2 patients, tumor vessels that initially remained patent disappeared on the delayed follow-up. A part of tumor necrosis after chemoembolisation of HCC with DEB seems to take place later than 2 days after TACE. CEUS may provide evidence for the sustained antitumor effect of DEB-TACE. Nevertheless, the ideal time for the imaging evaluation of tumor response remains to be defined.</description><identifier>ISSN: 0174-1551</identifier><identifier>EISSN: 1432-086X</identifier><identifier>DOI: 10.1007/s00270-010-9800-7</identifier><identifier>PMID: 20101403</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Aged ; ANTI-INFECTIVE AGENTS ; ANTIBIOTICS ; ANTINEOPLASTIC DRUGS ; Carcinoma, Hepatocellular - diagnostic imaging ; Carcinoma, Hepatocellular - mortality ; Carcinoma, Hepatocellular - pathology ; Carcinoma, Hepatocellular - therapy ; CARCINOMAS ; Cardiology ; Chemoembolization, Therapeutic - methods ; CONTRAST MEDIA ; DIAGNOSTIC TECHNIQUES ; DISEASES ; DOXORUBICIN ; Doxorubicin - administration & dosage ; DRUGS ; EMBOLI ; Female ; Follow-Up Studies ; HEPATOMAS ; Humans ; Image Enhancement - methods ; Imaging ; Liver - pathology ; Liver Neoplasms - diagnostic imaging ; Liver Neoplasms - mortality ; Liver Neoplasms - pathology ; Liver Neoplasms - therapy ; Male ; Medicine ; Medicine & Public Health ; Microspheres ; Middle Aged ; NECROSIS ; Necrosis - pathology ; Neoplasm Staging ; NEOPLASMS ; Nuclear Medicine ; ORGANIC COMPOUNDS ; PATHOLOGICAL CHANGES ; Phospholipids ; Pilot Projects ; Radiology ; RADIOLOGY AND NUCLEAR MEDICINE ; Sampling Studies ; Sulfur Hexafluoride ; Survival Rate ; Technical Note ; Tomography, X-Ray Computed - methods ; Treatment Outcome ; ULTRASONOGRAPHY ; Ultrasonography, Interventional - methods ; Ultrasound</subject><ispartof>Cardiovascular and interventional radiology, 2010-10, Vol.33 (5), p.1022-1027</ispartof><rights>Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2010</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c398t-c5e7b6011c794c01cc96ad92f313b5655351a8825b8d6a561eea785d25abc0d3</citedby><cites>FETCH-LOGICAL-c398t-c5e7b6011c794c01cc96ad92f313b5655351a8825b8d6a561eea785d25abc0d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00270-010-9800-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00270-010-9800-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20101403$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/21428923$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Moschouris, Hippocrates</creatorcontrib><creatorcontrib>Malagari, Katerina</creatorcontrib><creatorcontrib>Papadaki, Marina Georgiou</creatorcontrib><creatorcontrib>Kornezos, Ioannis</creatorcontrib><creatorcontrib>Matsaidonis, Dimitrios</creatorcontrib><title>Contrast-Enhanced Ultrasonography of Hepatocellular Carcinoma After Chemoembolisation Using Drug-Eluting Beads: A Pilot Study Focused on Sustained Tumor Necrosis</title><title>Cardiovascular and interventional radiology</title><addtitle>Cardiovasc Intervent Radiol</addtitle><addtitle>Cardiovasc Intervent Radiol</addtitle><description>The purpose of this study was to assess the use of contrast-enhanced ultrasonography (CEUS) and the sustained antitumor effect of drug-eluting beads used for transarterial chemoembolisation (TACE) of unresectable hepatocellular carcinoma (HCC). Ten patients with solitary, unresectable HCC underwent CEUS before, 2 days after, and 35 to 40 days after TACE using a standard dose (4 ml) of drug-eluting beads (DC Beads; Biocompatibles, Surrey, UK) preloaded with doxorubicin (25 mg doxorubicin/ml hydrated beads). For CEUS, a second-generation contrast agent (SonoVue, Bracco, Milan, Italy) and a low mechanical–index technique were used. A part of the tumor was characterized as necrotic if it showed complete lack of enhancement. The percentage of necrosis was calculated at the sonographic section that depicted the largest diameter of the tumor. Differences in the extent of early (2 days after TACE) and delayed (35 to 40 days after TACE) necrosis were quantitatively and subjectively assessed. Early post-TACE tumor necrosis ranged from 21% to 70% (mean 43.5% ± 19%). There was a statistically significant (
p
= 0.0012, paired Student
t
test) higher percentage of delayed tumor necrosis, which ranged from 24% to 88% (mean 52.3% ± 20.3%). Subjective evaluation showed a delayed obvious increase of the necrotic areas in 5 patients. In 2 patients, tumor vessels that initially remained patent disappeared on the delayed follow-up. A part of tumor necrosis after chemoembolisation of HCC with DEB seems to take place later than 2 days after TACE. CEUS may provide evidence for the sustained antitumor effect of DEB-TACE. Nevertheless, the ideal time for the imaging evaluation of tumor response remains to be defined.</description><subject>Aged</subject><subject>ANTI-INFECTIVE AGENTS</subject><subject>ANTIBIOTICS</subject><subject>ANTINEOPLASTIC DRUGS</subject><subject>Carcinoma, Hepatocellular - diagnostic imaging</subject><subject>Carcinoma, Hepatocellular - mortality</subject><subject>Carcinoma, Hepatocellular - pathology</subject><subject>Carcinoma, Hepatocellular - therapy</subject><subject>CARCINOMAS</subject><subject>Cardiology</subject><subject>Chemoembolization, Therapeutic - methods</subject><subject>CONTRAST MEDIA</subject><subject>DIAGNOSTIC TECHNIQUES</subject><subject>DISEASES</subject><subject>DOXORUBICIN</subject><subject>Doxorubicin - administration & dosage</subject><subject>DRUGS</subject><subject>EMBOLI</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>HEPATOMAS</subject><subject>Humans</subject><subject>Image Enhancement - methods</subject><subject>Imaging</subject><subject>Liver - 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Academic</collection><collection>OSTI.GOV</collection><jtitle>Cardiovascular and interventional radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Moschouris, Hippocrates</au><au>Malagari, Katerina</au><au>Papadaki, Marina Georgiou</au><au>Kornezos, Ioannis</au><au>Matsaidonis, Dimitrios</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Contrast-Enhanced Ultrasonography of Hepatocellular Carcinoma After Chemoembolisation Using Drug-Eluting Beads: A Pilot Study Focused on Sustained Tumor Necrosis</atitle><jtitle>Cardiovascular and interventional radiology</jtitle><stitle>Cardiovasc Intervent Radiol</stitle><addtitle>Cardiovasc Intervent Radiol</addtitle><date>2010-10-01</date><risdate>2010</risdate><volume>33</volume><issue>5</issue><spage>1022</spage><epage>1027</epage><pages>1022-1027</pages><issn>0174-1551</issn><eissn>1432-086X</eissn><abstract>The purpose of this study was to assess the use of contrast-enhanced ultrasonography (CEUS) and the sustained antitumor effect of drug-eluting beads used for transarterial chemoembolisation (TACE) of unresectable hepatocellular carcinoma (HCC). Ten patients with solitary, unresectable HCC underwent CEUS before, 2 days after, and 35 to 40 days after TACE using a standard dose (4 ml) of drug-eluting beads (DC Beads; Biocompatibles, Surrey, UK) preloaded with doxorubicin (25 mg doxorubicin/ml hydrated beads). For CEUS, a second-generation contrast agent (SonoVue, Bracco, Milan, Italy) and a low mechanical–index technique were used. A part of the tumor was characterized as necrotic if it showed complete lack of enhancement. The percentage of necrosis was calculated at the sonographic section that depicted the largest diameter of the tumor. Differences in the extent of early (2 days after TACE) and delayed (35 to 40 days after TACE) necrosis were quantitatively and subjectively assessed. Early post-TACE tumor necrosis ranged from 21% to 70% (mean 43.5% ± 19%). There was a statistically significant (
p
= 0.0012, paired Student
t
test) higher percentage of delayed tumor necrosis, which ranged from 24% to 88% (mean 52.3% ± 20.3%). Subjective evaluation showed a delayed obvious increase of the necrotic areas in 5 patients. In 2 patients, tumor vessels that initially remained patent disappeared on the delayed follow-up. A part of tumor necrosis after chemoembolisation of HCC with DEB seems to take place later than 2 days after TACE. CEUS may provide evidence for the sustained antitumor effect of DEB-TACE. Nevertheless, the ideal time for the imaging evaluation of tumor response remains to be defined.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>20101403</pmid><doi>10.1007/s00270-010-9800-7</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Cardiovascular and interventional radiology, 2010-10, Vol.33 (5), p.1022-1027 |
| issn | 0174-1551 1432-086X |
| language | eng |
| recordid | cdi_osti_scitechconnect_21428923 |
| source | MEDLINE; SpringerLink (Online service) |
| subjects | Aged ANTI-INFECTIVE AGENTS ANTIBIOTICS ANTINEOPLASTIC DRUGS Carcinoma, Hepatocellular - diagnostic imaging Carcinoma, Hepatocellular - mortality Carcinoma, Hepatocellular - pathology Carcinoma, Hepatocellular - therapy CARCINOMAS Cardiology Chemoembolization, Therapeutic - methods CONTRAST MEDIA DIAGNOSTIC TECHNIQUES DISEASES DOXORUBICIN Doxorubicin - administration & dosage DRUGS EMBOLI Female Follow-Up Studies HEPATOMAS Humans Image Enhancement - methods Imaging Liver - pathology Liver Neoplasms - diagnostic imaging Liver Neoplasms - mortality Liver Neoplasms - pathology Liver Neoplasms - therapy Male Medicine Medicine & Public Health Microspheres Middle Aged NECROSIS Necrosis - pathology Neoplasm Staging NEOPLASMS Nuclear Medicine ORGANIC COMPOUNDS PATHOLOGICAL CHANGES Phospholipids Pilot Projects Radiology RADIOLOGY AND NUCLEAR MEDICINE Sampling Studies Sulfur Hexafluoride Survival Rate Technical Note Tomography, X-Ray Computed - methods Treatment Outcome ULTRASONOGRAPHY Ultrasonography, Interventional - methods Ultrasound |
| title | Contrast-Enhanced Ultrasonography of Hepatocellular Carcinoma After Chemoembolisation Using Drug-Eluting Beads: A Pilot Study Focused on Sustained Tumor Necrosis |
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