Contrast-enhanced ultrasound evaluation of residual blood flow to hepatocellular carcinoma after treatment with transarterial chemoembolization using drug-eluting beads: a prospective study
To evaluate the accuracy and change over time of contrast-enhanced ultrasound (US) imaging for assessing residual blood flow after transarterial chemoembolization of hepatocellular carcinoma with drug-eluting beads at 2 different follow-up intervals. Data from 16 tumors treated by transarterial chem...
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| Veröffentlicht in: | Journal of ultrasound in medicine 2015-05, Vol.34 (5), p.859-867 |
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| creator | Shaw, Colette M Eisenbrey, John R Lyshchik, Andrej O'Kane, Patrick L Merton, Daniel A Machado, Priscilla Pino, Laura Brown, Daniel B Forsberg, Flemming |
| description | To evaluate the accuracy and change over time of contrast-enhanced ultrasound (US) imaging for assessing residual blood flow after transarterial chemoembolization of hepatocellular carcinoma with drug-eluting beads at 2 different follow-up intervals.
Data from 16 tumors treated by transarterial chemoembolization with drug-eluting beads were successfully obtained. As part of the study, patients provided consent to undergo contrast-enhanced US examinations the morning before embolization, 1 to 2 weeks after embolization, and the morning before follow-up contrast-enhanced magnetic resonance imaging (MRI) or computed tomography (CT) (1 month after embolization). Blinded review of contrast-enhanced US and MRI/CT studies were performed by 2 radiologists who evaluated residual flow as no change, partial change, or no residual flow. Inter- and intra-reader variability rates were calculated before discordant individual reads were settled by consensus.
The only adverse event reported during the contrast-enhanced US examinations was a single episode of transient back pain. Contrast-enhanced US at 1 to 2 weeks after embolization (n = 14) resulted in 100% sensitivity, specificity, positive predictive value, negative predictive value, and accuracy. Contrast-enhanced US 1 month after embolization (n = 15) resulted in 75% sensitivity, 100% specificity, 100% positive predictive value, 92% negative predictive value, and 93% accuracy. Inter-reader agreement was 86% for contrast-enhanced US at 1 to 2 weeks, 93% for contrast-enhanced US at 1 month, and 100% for contrast-enhanced MRI/CT at 1 month, whereas intra-reader agreement was 71% for contrast-enhanced US at 1 to 2 weeks, 87% for contrast-enhanced US at 1 month, and 91% for MRI/CT.
Contrast-enhanced US imaging at 1 to 2 weeks after the procedure may be a viable alternative to MRI/CT for evaluating residual blood flow after transarterial chemoembolization with drug-eluting beads, albeit with a higher degree of reader variability. |
| doi_str_mv | 10.7863/ultra.34.5.859 |
| format | Article |
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Data from 16 tumors treated by transarterial chemoembolization with drug-eluting beads were successfully obtained. As part of the study, patients provided consent to undergo contrast-enhanced US examinations the morning before embolization, 1 to 2 weeks after embolization, and the morning before follow-up contrast-enhanced magnetic resonance imaging (MRI) or computed tomography (CT) (1 month after embolization). Blinded review of contrast-enhanced US and MRI/CT studies were performed by 2 radiologists who evaluated residual flow as no change, partial change, or no residual flow. Inter- and intra-reader variability rates were calculated before discordant individual reads were settled by consensus.
The only adverse event reported during the contrast-enhanced US examinations was a single episode of transient back pain. Contrast-enhanced US at 1 to 2 weeks after embolization (n = 14) resulted in 100% sensitivity, specificity, positive predictive value, negative predictive value, and accuracy. Contrast-enhanced US 1 month after embolization (n = 15) resulted in 75% sensitivity, 100% specificity, 100% positive predictive value, 92% negative predictive value, and 93% accuracy. Inter-reader agreement was 86% for contrast-enhanced US at 1 to 2 weeks, 93% for contrast-enhanced US at 1 month, and 100% for contrast-enhanced MRI/CT at 1 month, whereas intra-reader agreement was 71% for contrast-enhanced US at 1 to 2 weeks, 87% for contrast-enhanced US at 1 month, and 91% for MRI/CT.
Contrast-enhanced US imaging at 1 to 2 weeks after the procedure may be a viable alternative to MRI/CT for evaluating residual blood flow after transarterial chemoembolization with drug-eluting beads, albeit with a higher degree of reader variability.</description><identifier>ISSN: 0278-4297</identifier><identifier>EISSN: 1550-9613</identifier><identifier>DOI: 10.7863/ultra.34.5.859</identifier><identifier>PMID: 25911704</identifier><language>eng</language><publisher>England</publisher><subject>Aged ; Antineoplastic Agents - administration & dosage ; Carcinoma, Hepatocellular - diagnostic imaging ; Carcinoma, Hepatocellular - drug therapy ; Chemoembolization, Therapeutic - methods ; Contrast Media ; Delayed-Action Preparations - administration & dosage ; Doxorubicin - administration & dosage ; Drug-Eluting Stents ; Female ; Hemostatics - administration & dosage ; Humans ; Liver Neoplasms - diagnostic imaging ; Liver Neoplasms - drug therapy ; Male ; Middle Aged ; Neovascularization, Pathologic - diagnostic imaging ; Neovascularization, Pathologic - drug therapy ; Observer Variation ; Perfusion Imaging - methods ; Prognosis ; Prospective Studies ; Treatment Outcome ; Ultrasonography - methods</subject><ispartof>Journal of ultrasound in medicine, 2015-05, Vol.34 (5), p.859-867</ispartof><rights>2015 by the American Institute of Ultrasound in Medicine.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c250t-59fd78d3e6b556a015ce01db2a8f83365806079bba49faf5e1a9dc9e46cb44733</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25911704$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shaw, Colette M</creatorcontrib><creatorcontrib>Eisenbrey, John R</creatorcontrib><creatorcontrib>Lyshchik, Andrej</creatorcontrib><creatorcontrib>O'Kane, Patrick L</creatorcontrib><creatorcontrib>Merton, Daniel A</creatorcontrib><creatorcontrib>Machado, Priscilla</creatorcontrib><creatorcontrib>Pino, Laura</creatorcontrib><creatorcontrib>Brown, Daniel B</creatorcontrib><creatorcontrib>Forsberg, Flemming</creatorcontrib><title>Contrast-enhanced ultrasound evaluation of residual blood flow to hepatocellular carcinoma after treatment with transarterial chemoembolization using drug-eluting beads: a prospective study</title><title>Journal of ultrasound in medicine</title><addtitle>J Ultrasound Med</addtitle><description>To evaluate the accuracy and change over time of contrast-enhanced ultrasound (US) imaging for assessing residual blood flow after transarterial chemoembolization of hepatocellular carcinoma with drug-eluting beads at 2 different follow-up intervals.
Data from 16 tumors treated by transarterial chemoembolization with drug-eluting beads were successfully obtained. As part of the study, patients provided consent to undergo contrast-enhanced US examinations the morning before embolization, 1 to 2 weeks after embolization, and the morning before follow-up contrast-enhanced magnetic resonance imaging (MRI) or computed tomography (CT) (1 month after embolization). Blinded review of contrast-enhanced US and MRI/CT studies were performed by 2 radiologists who evaluated residual flow as no change, partial change, or no residual flow. Inter- and intra-reader variability rates were calculated before discordant individual reads were settled by consensus.
The only adverse event reported during the contrast-enhanced US examinations was a single episode of transient back pain. Contrast-enhanced US at 1 to 2 weeks after embolization (n = 14) resulted in 100% sensitivity, specificity, positive predictive value, negative predictive value, and accuracy. Contrast-enhanced US 1 month after embolization (n = 15) resulted in 75% sensitivity, 100% specificity, 100% positive predictive value, 92% negative predictive value, and 93% accuracy. Inter-reader agreement was 86% for contrast-enhanced US at 1 to 2 weeks, 93% for contrast-enhanced US at 1 month, and 100% for contrast-enhanced MRI/CT at 1 month, whereas intra-reader agreement was 71% for contrast-enhanced US at 1 to 2 weeks, 87% for contrast-enhanced US at 1 month, and 91% for MRI/CT.
Contrast-enhanced US imaging at 1 to 2 weeks after the procedure may be a viable alternative to MRI/CT for evaluating residual blood flow after transarterial chemoembolization with drug-eluting beads, albeit with a higher degree of reader variability.</description><subject>Aged</subject><subject>Antineoplastic Agents - administration & dosage</subject><subject>Carcinoma, Hepatocellular - diagnostic imaging</subject><subject>Carcinoma, Hepatocellular - drug therapy</subject><subject>Chemoembolization, Therapeutic - methods</subject><subject>Contrast Media</subject><subject>Delayed-Action Preparations - administration & dosage</subject><subject>Doxorubicin - administration & dosage</subject><subject>Drug-Eluting Stents</subject><subject>Female</subject><subject>Hemostatics - administration & dosage</subject><subject>Humans</subject><subject>Liver Neoplasms - diagnostic imaging</subject><subject>Liver Neoplasms - drug therapy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neovascularization, Pathologic - diagnostic imaging</subject><subject>Neovascularization, Pathologic - drug therapy</subject><subject>Observer Variation</subject><subject>Perfusion Imaging - methods</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Treatment Outcome</subject><subject>Ultrasonography - methods</subject><issn>0278-4297</issn><issn>1550-9613</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kU1v1DAQhi0EokvhyhH5yCXBjmMn5oZWfFSqxAXO0cSedI0ce_FHq_Lf-G9ku6Wn0WjeeebjJeQtZ-0wKvGh-pKgFX0r21HqZ2THpWSNVlw8JzvWDWPTd3q4IK9y_sVYx_jQvyQXndScD6zfkb_7GDZCLg2GAwSDlj4gc6zBUrwFX6G4GGhcaMLsbAVPZx-jpYuPd7REesAjlGjQ--ohUQPJuBBXoLAUTLQkhLJiKPTOlcOWQsiQtorbSOaAa8R1jt79Oc-p2YUbalO9adDXckpmBJs_UqDHFPMRTXG3SHOp9v41ebGAz_jmMV6Sn18-_9h_a66_f73af7puTCdZaaRe7DBagWqWUgHj0iDjdu5gXEYhlByZYoOeZ-j1AotEDtoajb0yc98PQlyS92futsHvirlMq8uniyFgrHnialBCjEqrTdqepWZbNidcpmNyK6T7ibPpZNn08N9J9JOcNsu2hneP7DqvaJ_k_z0S_wApl5qF</recordid><startdate>201505</startdate><enddate>201505</enddate><creator>Shaw, Colette M</creator><creator>Eisenbrey, John R</creator><creator>Lyshchik, Andrej</creator><creator>O'Kane, Patrick L</creator><creator>Merton, Daniel A</creator><creator>Machado, Priscilla</creator><creator>Pino, Laura</creator><creator>Brown, Daniel B</creator><creator>Forsberg, Flemming</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201505</creationdate><title>Contrast-enhanced ultrasound evaluation of residual blood flow to hepatocellular carcinoma after treatment with transarterial chemoembolization using drug-eluting beads: a prospective study</title><author>Shaw, Colette M ; Eisenbrey, John R ; Lyshchik, Andrej ; O'Kane, Patrick L ; Merton, Daniel A ; Machado, Priscilla ; Pino, Laura ; Brown, Daniel B ; Forsberg, Flemming</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c250t-59fd78d3e6b556a015ce01db2a8f83365806079bba49faf5e1a9dc9e46cb44733</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Antineoplastic Agents - administration & dosage</topic><topic>Carcinoma, Hepatocellular - diagnostic imaging</topic><topic>Carcinoma, Hepatocellular - drug therapy</topic><topic>Chemoembolization, Therapeutic - methods</topic><topic>Contrast Media</topic><topic>Delayed-Action Preparations - administration & dosage</topic><topic>Doxorubicin - administration & dosage</topic><topic>Drug-Eluting Stents</topic><topic>Female</topic><topic>Hemostatics - administration & dosage</topic><topic>Humans</topic><topic>Liver Neoplasms - diagnostic imaging</topic><topic>Liver Neoplasms - drug therapy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neovascularization, Pathologic - diagnostic imaging</topic><topic>Neovascularization, Pathologic - drug therapy</topic><topic>Observer Variation</topic><topic>Perfusion Imaging - methods</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Treatment Outcome</topic><topic>Ultrasonography - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shaw, Colette M</creatorcontrib><creatorcontrib>Eisenbrey, John R</creatorcontrib><creatorcontrib>Lyshchik, Andrej</creatorcontrib><creatorcontrib>O'Kane, Patrick L</creatorcontrib><creatorcontrib>Merton, Daniel A</creatorcontrib><creatorcontrib>Machado, Priscilla</creatorcontrib><creatorcontrib>Pino, Laura</creatorcontrib><creatorcontrib>Brown, Daniel B</creatorcontrib><creatorcontrib>Forsberg, Flemming</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of ultrasound in medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shaw, Colette M</au><au>Eisenbrey, John R</au><au>Lyshchik, Andrej</au><au>O'Kane, Patrick L</au><au>Merton, Daniel A</au><au>Machado, Priscilla</au><au>Pino, Laura</au><au>Brown, Daniel B</au><au>Forsberg, Flemming</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Contrast-enhanced ultrasound evaluation of residual blood flow to hepatocellular carcinoma after treatment with transarterial chemoembolization using drug-eluting beads: a prospective study</atitle><jtitle>Journal of ultrasound in medicine</jtitle><addtitle>J Ultrasound Med</addtitle><date>2015-05</date><risdate>2015</risdate><volume>34</volume><issue>5</issue><spage>859</spage><epage>867</epage><pages>859-867</pages><issn>0278-4297</issn><eissn>1550-9613</eissn><abstract>To evaluate the accuracy and change over time of contrast-enhanced ultrasound (US) imaging for assessing residual blood flow after transarterial chemoembolization of hepatocellular carcinoma with drug-eluting beads at 2 different follow-up intervals.
Data from 16 tumors treated by transarterial chemoembolization with drug-eluting beads were successfully obtained. As part of the study, patients provided consent to undergo contrast-enhanced US examinations the morning before embolization, 1 to 2 weeks after embolization, and the morning before follow-up contrast-enhanced magnetic resonance imaging (MRI) or computed tomography (CT) (1 month after embolization). Blinded review of contrast-enhanced US and MRI/CT studies were performed by 2 radiologists who evaluated residual flow as no change, partial change, or no residual flow. Inter- and intra-reader variability rates were calculated before discordant individual reads were settled by consensus.
The only adverse event reported during the contrast-enhanced US examinations was a single episode of transient back pain. Contrast-enhanced US at 1 to 2 weeks after embolization (n = 14) resulted in 100% sensitivity, specificity, positive predictive value, negative predictive value, and accuracy. Contrast-enhanced US 1 month after embolization (n = 15) resulted in 75% sensitivity, 100% specificity, 100% positive predictive value, 92% negative predictive value, and 93% accuracy. Inter-reader agreement was 86% for contrast-enhanced US at 1 to 2 weeks, 93% for contrast-enhanced US at 1 month, and 100% for contrast-enhanced MRI/CT at 1 month, whereas intra-reader agreement was 71% for contrast-enhanced US at 1 to 2 weeks, 87% for contrast-enhanced US at 1 month, and 91% for MRI/CT.
Contrast-enhanced US imaging at 1 to 2 weeks after the procedure may be a viable alternative to MRI/CT for evaluating residual blood flow after transarterial chemoembolization with drug-eluting beads, albeit with a higher degree of reader variability.</abstract><cop>England</cop><pmid>25911704</pmid><doi>10.7863/ultra.34.5.859</doi><tpages>9</tpages></addata></record> |
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| subjects | Aged Antineoplastic Agents - administration & dosage Carcinoma, Hepatocellular - diagnostic imaging Carcinoma, Hepatocellular - drug therapy Chemoembolization, Therapeutic - methods Contrast Media Delayed-Action Preparations - administration & dosage Doxorubicin - administration & dosage Drug-Eluting Stents Female Hemostatics - administration & dosage Humans Liver Neoplasms - diagnostic imaging Liver Neoplasms - drug therapy Male Middle Aged Neovascularization, Pathologic - diagnostic imaging Neovascularization, Pathologic - drug therapy Observer Variation Perfusion Imaging - methods Prognosis Prospective Studies Treatment Outcome Ultrasonography - methods |
| title | Contrast-enhanced ultrasound evaluation of residual blood flow to hepatocellular carcinoma after treatment with transarterial chemoembolization using drug-eluting beads: a prospective study |
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