Sono-hepatic-arteriography (Sono-HA) in the assessment of hepatocellular carcinoma in patients undergoing transcatheter arterial chemoembolization (TACE)

Ultraschall Med. 2010 Jun;31(3):270-5. doi: 10.1055/s-0029-1245242. Epub 2010 Apr 20.

Abstract

Purpose: The aim of our study was to evaluate sono-hepatic-arteriography in patients with hepatocellular carcinoma undergoing transcatheter arterial chemoembolization.

Materials and methods: We evaluated 15 patients with hepatocellular carcinoma undergoing TACE who presented in our institution from February 2006 to May 2008. All patients underwent a conventional B-mode ultrasound examination using a high-end machine and a multi-frequency transducer (2.5 - 4 MHz) before dynamic contrast-enhanced ultrasound examination was carried out. For the sono-hepatic-arteriography 1 ml SonoVue was injected as a bolus using the formerly placed intraarterial catheter. Biphasic enhanced computed tomography was performed using a 16-slice CT scanner up to 48 hours before transcatheter arterial chemoembolization and during follow-up.

Results: The lesion size (of the largest lesion) ranged from 1 to 13 centimeters in their largest diameter (mean: 4.8 cm). Contrast-enhanced ultrasound diagnosed more lesions than B-mode sonography in eight cases and more lesions than computed tomography in 5 patients. The findings of sono-hepatic-arteriography were correct in fourteen cases (93.3 %). Direct impact on patient management was seen in eleven patients (73.3 %).

Conclusion: We were able to show that the application of an intraarterial sonographic contrast agent during embolization is able to diagnose new lesions on the one hand and to assess the embolization success on the other. This might improve transcatheter arterial chemoembolization results and patient outcome.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Angiography / methods*
  • Angiography, Digital Subtraction
  • Carcinoma, Hepatocellular / blood supply*
  • Carcinoma, Hepatocellular / diagnostic imaging*
  • Carcinoma, Hepatocellular / therapy
  • Combined Modality Therapy
  • Contrast Media / administration & dosage
  • Electrocoagulation
  • Embolization, Therapeutic*
  • Female
  • Humans
  • Liver Neoplasms / blood supply*
  • Liver Neoplasms / diagnostic imaging*
  • Liver Neoplasms / therapy
  • Liver Transplantation
  • Male
  • Middle Aged
  • Palliative Care
  • Phospholipids
  • Sensitivity and Specificity
  • Sulfur Hexafluoride
  • Tomography, Spiral Computed
  • Ultrasonography

Substances

  • Contrast Media
  • Phospholipids
  • contrast agent BR1
  • Sulfur Hexafluoride