Top

Published in:

01-08-2021 | Ultrasound | Special Section: HCC Treatment

Contrast-enhanced ultrasound (CEUS) in HCC diagnosis and assessment of tumor response to locoregional therapies

Authors: John R. Eisenbrey, Helena Gabriel, Esika Savsani, Andrej Lyshchik

Published in: Abdominal Radiology | Issue 8/2021

Abstract

Hepatocellular carcinoma (HCC) is a global problem constituting the second leading cause of cancer deaths worldwide, thereby necessitating an accurate and cost-effective solution for managing care. Ultrasound is well poised to address this need due to its low cost, portability, safety, and excellent temporal resolution. The role of ultrasound for HCC screening has been well established and supported by multiple international guidelines. Similarly, contrast-enhanced ultrasound (CEUS) can be used for the characterization of focal liver lesions in high-risk populations, and standardized criteria for CEUS have been established by the American College of Radiology Liver Imaging Reporting & Data System (LI-RADS). Following HCC identification, CEUS can also be highly beneficial in treatment planning, delivery, and monitoring HCC response to locoregional therapies. Specific advantages of CEUS include providing real-time treatment guidance and improved diagnostic performance for the detection of residual tumor viability or recurrence, thereby identifying patients in need of retreatment substantially earlier than contrast-enhanced CT and MRI. This review provides a primer on ultrasound and CEUS for the screening and characterization of HCC, with an emphasis on assessing tumor response to locoregional therapies.

Horowitz JM, Kamel IR, Arif-Tiwari H, Asrani SK, Hindman NM, Kaur H, McNamara MM, Noto RB, Qayyum A, Lalani T (2017) ACR Appropriateness Criteria(®) Chronic Liver Disease. J Am Coll Radiol 14:S391-s405. https://doi.org/10.1016/j.jacr.2017.08.045CrossRefPubMed

American College of Radiology Committee on LI-RADS® (2018) CT/MRI LI-RADS® v2018 CORE. https://www.acr.org/-/media/ACR/Files/RADS/LI-RADS/LI-RADS-2018-Core.pdf?%20la=en. Accessed 01 January 2021

Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F (2012) GLOBOCAN 2012: Estimated Cancer Incidence, Mortality and Prevalence Worldwide in 2012. International Agency for Research on Cancer. globocan.iarc.fr. Accessed 01 January 2021

National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) Program (2009) SEER*Stat Database: Incidence-SEER Research Data 9 Registries. Accessed 01 January 2021

Wilson JM, Jungner YG (1968) Principles and practices of screening for disease. World Health Organization. https://apps.who.int/iris/handle/10665/37650. Accessed 01 January 2021

Zhang BH, Yang BH, Tang ZY (2004) Randomized controlled trial of screening for hepatocellular carcinoma. J Cancer Res Clin Oncol 130:417-22. https://doi.org/10.1007/s00432-004-0552-0CrossRefPubMed

Yang B, Zhang B, Xu Y, Wang W, Shen Y, Zhang A, Xu Z (1997) Prospective study of early detection for primary liver cancer. J Cancer Res Clin Oncol 123:357-60. https://doi.org/10.1007/BF01438313CrossRefPubMed

American College of Radiology Committee on LI-RADS® (2017) Ultrasound LI-RADS® v2017. https://www.acr.org/Clinical-Resources/Reporting-and-Data-Systems/LI-RADS/Ultrasound-LI-RADS-v2017. Accessed 15 January 2021

American College of Radiology Committee on LI-RADS® (2017) CEUS LI-RADS® v2017. https://www.acr.org/Clinical-Resources/Reporting-and-Data-Systems/LI-RADS/CEUS-LI-RADS-v2017. Accessed 15 January 2021

10.

Zhang J, Yu Y, Li Y, Wei L (2017) Diagnostic value of contrast-enhanced ultrasound in hepatocellular carcinoma: a meta-analysis with evidence from 1998 to 2016. Oncotarget 8:75418-75426. https://doi.org/10.18632/oncotarget.20049CrossRefPubMedPubMedCentral

11.

Huang JY, Li JW, Lu Q, Luo Y, Lin L, Shi YJ, Li T, Liu JB, Lyshchik A (2020) Diagnostic Accuracy of CEUS LI-RADS for the Characterization of Liver Nodules 20 mm or Smaller in Patients at Risk for Hepatocellular Carcinoma. Radiology 294:329-339. https://doi.org/10.1148/radiol.2019191086CrossRefPubMed

12.

Lyshchik A (2019) Specialty Imaging: Fundamentals of CEUS. Elsevier, Philadelphia

13.

Forner A, Reig M, Bruix J (2018) Hepatocellular carcinoma. Lancet 391:1301-1314. https://doi.org/10.1016/S0140-6736(18)30010-2CrossRefPubMed

14.

Head HW, Dodd GD, 3rd (2004) Thermal ablation for hepatocellular carcinoma. Gastroenterology 127:S167-78. https://doi.org/10.1053/j.gastro.2004.09.031CrossRefPubMed

15.

Sala M, Llovet JM, Vilana R, Bianchi L, Solé M, Ayuso C, Brú C, Bruix J (2004) Initial response to percutaneous ablation predicts survival in patients with hepatocellular carcinoma. Hepatology 40:1352-60. https://doi.org/10.1002/hep.20465CrossRefPubMed

16.

Ayuso C, Rimola J, García-Criado A (2012) Imaging of HCC. Abdom Imaging 37:215-30. https://doi.org/10.1007/s00261-011-9794-xCrossRefPubMed

17.

Madsen HH, Rasmussen F (2011) Contrast-enhanced ultrasound in oncology. Cancer Imaging 11 Spec No A:S167–73. https://doi.org/10.1102/1470-7330.2011.9042

18.

Piscaglia F, Nolsøe C, Dietrich CF, Cosgrove DO, Gilja OH, Bachmann Nielsen M, Albrecht T, Barozzi L, Bertolotto M, Catalano O, Claudon M, Clevert DA, Correas JM, D'Onofrio M, Drudi FM, Eyding J, Giovannini M, Hocke M, Ignee A, Jung EM, Klauser AS, Lassau N, Leen E, Mathis G, Saftoiu A, Seidel G, Sidhu PS, ter Haar G, Timmerman D, Weskott HP (2012) The EFSUMB Guidelines and Recommendations on the Clinical Practice of Contrast Enhanced Ultrasound (CEUS): update 2011 on non-hepatic applications. Ultraschall Med 33:33-59. https://doi.org/10.1055/s-0031-1281676CrossRefPubMed

19.

Huang DY, Yusuf GT, Daneshi M, Husainy MA, Ramnarine R, Sellars ME, Sidhu PS (2017) Contrast-enhanced US-guided Interventions: Improving Success Rate and Avoiding Complications Using US Contrast Agents. Radiographics 37:652-664. https://doi.org/10.1148/rg.2017160123CrossRefPubMed

20.

Minami Y, Kudo M, Kawasaki T, Chung H, Ogawa C, Shiozaki H (2004) Treatment of hepatocellular carcinoma with percutaneous radiofrequency ablation: usefulness of contrast harmonic sonography for lesions poorly defined with B-mode sonography. AJR Am J Roentgenol 183:153-6. https://doi.org/10.2214/ajr.183.1.1830153CrossRefPubMed

21.

Yan SY, Zhang Y, Sun C, Cao HX, Li GM, Wang YQ, Fan JG (2016) Comparison of real-time contrast-enhanced ultrasonography and standard ultrasonography in liver cancer microwave ablation. Exp Ther Med 12:1345-1348. https://doi.org/10.3892/etm.2016.3448CrossRefPubMedPubMedCentral

22.

Chen MH, Yang W, Yan K, Zou MW, Solbiati L, Liu JB, Dai Y (2004) Large liver tumors: protocol for radiofrequency ablation and its clinical application in 110 patients--mathematic model, overlapping mode, and electrode placement process. Radiology 232:260-71. https://doi.org/10.1148/radiol.2321030821CrossRefPubMed

23.

Mauri G, Porazzi E, Cova L, Restelli U, Tondolo T, Bonfanti M, Cerri A, Ierace T, Croce D, Solbiati L (2014) Intraprocedural contrast-enhanced ultrasound (CEUS) in liver percutaneous radiofrequency ablation: clinical impact and health technology assessment. Insights Imaging 5:209-16. https://doi.org/10.1007/s13244-014-0315-7CrossRefPubMedPubMedCentral

24.

Zhao X, Wang W, Zhang S, Liu J, Zhang F, Ji C, Li X, Gan W, Zhang G, Guo H (2012) Improved outcome of percutaneous radiofrequency ablation in renal cell carcinoma: a retrospective study of intraoperative contrast-enhanced ultrasonography in 73 patients. Abdom Imaging 37:885-91. https://doi.org/10.1007/s00261-011-9828-4CrossRefPubMed

25.

Francica G, Meloni MF, Riccardi L, de Sio I, Terracciano F, Caturelli E, Iadevaia MD, Amoruso A, Roselli P, Chiang J, Scaglione M, Pompili M (2018) Ablation treatment of primary and secondary liver tumors under contrast-enhanced ultrasound guidance in field practice of interventional ultrasound centers. A multicenter study. Eur J Radiol 105:96-101. https://doi.org/10.1016/j.ejrad.2018.05.030CrossRefPubMed

26.

Meloni MF, Andreano A, Zimbaro F, Lava M, Lazzaroni S, Sironi S (2012) Contrast enhanced ultrasound: Roles in immediate post-procedural and 24-h evaluation of the effectiveness of thermal ablation of liver tumors. J Ultrasound 15:207-14. https://doi.org/10.1016/j.jus.2012.09.001CrossRefPubMedPubMedCentral

27.

Roccarina D, Garcovich M, Ainora ME, Riccardi L, Pompili M, Gasbarrini A, Zocco MA (2015) Usefulness of contrast enhanced ultrasound in monitoring therapeutic response after hepatocellular carcinoma treatment. World J Hepatol 7:1866-74. https://doi.org/10.4254/wjh.v7.i14.1866CrossRefPubMedPubMedCentral

28.

Du J, Li HL, Zhai B, Chang S, Li FH (2015) Radiofrequency ablation for hepatocellular carcinoma: utility of conventional ultrasound and contrast-enhanced ultrasound in guiding and assessing early therapeutic response and short-term follow-up results. Ultrasound Med Biol 41:2400-11. https://doi.org/10.1016/j.ultrasmedbio.2015.05.004CrossRefPubMed

29.

Pregler B, Beyer LP, Wiesinger I, Nießen C, Jung EM, Stroszczynski C, Wiggermann P (2016) Microwave ablation of large HCC lesions: Added value of CEUS examinations for ablation success control. Clin Hemorheol Microcirc 64:483-490. https://doi.org/10.3233/CH-168113CrossRefPubMed

30.

Qu P, Yu X, Liang P, Cheng Z, Han Z, Liu F, Yu J (2013) Contrast-enhanced ultrasound in the characterization of hepatocellular carcinomas treated by ablation: comparison with contrast-enhanced magnetic resonance imaging. Ultrasound Med Biol 39:1571-9. https://doi.org/10.1016/j.ultrasmedbio.2013.03.030CrossRefPubMed

31.

Monsky W, Keravnou C, Averkiou M (2019) Contrast-enhanced ultrasound to ultrasound fusion during microwave ablation: feasibility study in a perfused porcine liver model. J Ultrasound 22:323-335. https://doi.org/10.1007/s40477-019-00366-5CrossRefPubMedPubMedCentral

32.

Park HJ, Lee MW, Rhim H, Cha DI, Kang TW, Lim S, Song KD, Lim HK (2015) Percutaneous ultrasonography-guided radiofrequency ablation of hepatocellular carcinomas: usefulness of image fusion with three-dimensional ultrasonography. Clin Radiol 70:387-94. https://doi.org/10.1016/j.crad.2014.12.003CrossRefPubMed

33.

Xu EJ, Lv SM, Li K, Long YL, Zeng QJ, Su ZZ, Zheng RQ (2018) Immediate evaluation and guidance of liver cancer thermal ablation by three-dimensional ultrasound/contrast-enhanced ultrasound fusion imaging. Int J Hyperthermia 34:870-876. https://doi.org/10.1080/02656736.2017.1373306CrossRefPubMed

34.

Mauri G, Gennaro N, De Beni S, Ierace T, Goldberg SN, Rodari M, Solbiati LA (2019) Real-Time US-(18)FDG-PET/CT Image Fusion for Guidance of Thermal Ablation of (18)FDG-PET-Positive Liver Metastases: The Added Value of Contrast Enhancement. Cardiovasc Intervent Radiol 42:60-68.https://doi.org/10.1007/s00270-018-2082-1CrossRefPubMed

35.

Clevert DA, Paprottka PM, Helck A, Reiser M, Trumm CG (2012) Image fusion in the management of thermal tumor ablation of the liver. Clin Hemorheol Microcirc 52:205-16.https://doi.org/10.3233/CH-2012-1598CrossRefPubMed

36.

Turtulici G, Orlandi D, Corazza A, Sartoris R, Derchi LE, Silvestri E, Baek JH (2014) Percutaneous radiofrequency ablation of benign thyroid nodules assisted by a virtual needle tracking system. Ultrasound Med Biol 40:1447-52. https://doi.org/10.1016/j.ultrasmedbio.2014.02.017CrossRefPubMed

37.

Gonsalves CF, Brown DB (2009) Chemoembolization of hepatic malignancy. Abdom Imaging 34:557-65.https://doi.org/10.1007/s00261-008-9446-yCrossRefPubMed

38.

Bruix J, Llovet JM (2002) Prognostic prediction and treatment strategy in hepatocellular carcinoma. Hepatology 35:519-24.https://doi.org/10.1053/jhep.2002.32089CrossRefPubMed

39.

Brown DB, Nikolic B, Covey AM, Nutting CW, Saad WE, Salem R, Sofocleous CT, Sze DY (2012) Quality improvement guidelines for transhepatic arterial chemoembolization, embolization, and chemotherapeutic infusion for hepatic malignancy. J Vasc Interv Radiol 23:287-94.https://doi.org/10.1016/j.jvir.2011.11.029CrossRefPubMed

40.

Yan FH, Zhou KR, Cheng JM, Wang JH, Yan ZP, Da RR, Fan J, Ji Y (2002) Role and limitation of FMPSPGR dynamic contrast scanning in the follow-up of patients with hepatocellular carcinoma treated by TACE. World J Gastroenterol 8:658-62. https://doi.org/10.3748/wjg.v8.i4.658CrossRefPubMedPubMedCentral

41.

Iqbal SI, Stuart KE (2018) Assessment of tumor response in patients receiving systemic and nonsurgical locoregional treatment of hepatocellular cancer. In: Goldberg RM (ed). UpToDate. Waltham, MA

42.

Imaeda T, Yamawaki Y, Seki M, Goto H, Iinuma G, Kanematsu M, Mochizuki R, Doi H, Saji S, Shimokawa K (1993) Lipiodol retention and massive necrosis after lipiodol-chemoembolization of hepatocellular carcinoma: correlation between computed tomography and histopathology. Cardiovasc Intervent Radiol 16:209-13.https://doi.org/10.1007/BF02602962CrossRefPubMed

43.

Varela M, Real MI, Burrel M, Forner A, Sala M, Brunet M, Ayuso C, Castells L, Montañá X, Llovet JM, Bruix J (2007) Chemoembolization of hepatocellular carcinoma with drug eluting beads: efficacy and doxorubicin pharmacokinetics. J Hepatol 46:474-81.https://doi.org/10.1016/j.jhep.2006.10.020CrossRefPubMed

44.

Minami Y, Kudo M, Kawasaki T, Kitano M, Chung H, Maekawa K, Shiozaki H (2003) Transcatheter arterial chemoembolization of hepatocellular carcinoma: usefulness of coded phase-inversion harmonic sonography. AJR Am J Roentgenol 180:703-8.https://doi.org/10.2214/ajr.180.3.1800703CrossRefPubMed

45.

Morimoto M, Shirato K, Sugimori K, Kokawa A, Tomita N, Saito T, Imada T, Tanaka N, Nozawa A, Numata K, Tanaka K (2003) Contrast-enhanced harmonic gray-scale sonographic-histologic correlation of the therapeutic effects of transcatheter arterial chemoembolization in patients with hepatocellular carcinoma. AJR Am J Roentgenol 181:65-9.https://doi.org/10.2214/ajr.181.1.1810065CrossRefPubMed

46.

Kono Y, Lucidarme O, Choi SH, Rose SC, Hassanein TI, Alpert E, Mattrey RF (2007) Contrast-enhanced ultrasound as a predictor of treatment efficacy within 2 weeks after transarterial chemoembolization of hepatocellular carcinoma. In: J Vasc Interv Radiol, United States, pp 57–65.https://doi.org/10.1016/j.jvir.2006.10.016

47.

Xia Y, Kudo M, Minami Y, Hatanaka K, Ueshima K, Chung H, Hagiwara S, Inoue T, Ishikawa E, Kitai S, Takahashi S, Tatsumi C, Ueda T, Hayaishi S, Maekawa K (2008) Response evaluation of transcatheter arterial chemoembolization in hepatocellular carcinomas: the usefulness of sonazoid-enhanced harmonic sonography. Oncology 75 Suppl 1:99-105.https://doi.org/10.1159/000173430CrossRefPubMed

48.

Shaw CM, Eisenbrey JR, Lyshchik A, O'Kane PL, Merton DA, Machado P, Pino L, Brown DB, Forsberg F (2015) Contrast-enhanced ultrasound evaluation of residual blood flow to hepatocellular carcinoma after treatment with transarterial chemoembolization using drug-eluting beads: a prospective study. J Ultrasound Med 34:859-67. https://doi.org/10.7863/ultra.34.5.859CrossRefPubMed

49.

Liu M, Lin MX, Lu MD, Xu ZF, Zheng KG, Wang W, Kuang M, Zhuang WQ, Xie XY (2015) Comparison of contrast-enhanced ultrasound and contrast-enhanced computed tomography in evaluating the treatment response to transcatheter arterial chemoembolization of hepatocellular carcinoma using modified RECIST. Eur Radiol 25:2502-11.https://doi.org/10.1007/s00330-015-3611-9CrossRefPubMed

50.

Watanabe Y, Ogawa M, Kumagawa M, Hirayama M, Miura T, Matsumoto N, Nakagawara H, Yamamoto T, Moriyama M (2020) Utility of Contrast-Enhanced Ultrasound for Early Therapeutic Evaluation of Hepatocellular Carcinoma After Transcatheter Arterial Chemoembolization. J Ultrasound Med 39:431-440.https://doi.org/10.1002/jum.15118CrossRefPubMed

51.

Kim HJ, Kim TK, Kim PN, Kim AY, Ko EY, Kim KW, Sung KB, Ha HK, Kim HC, Lee MG (2006) Assessment of the therapeutic response of hepatocellular carcinoma treated with transcatheter arterial chemoembolization: comparison of contrast-enhanced sonography and 3-phase computed tomography. J Ultrasound Med 25:477-86.https://doi.org/10.7863/jum.2006.25.4.477CrossRefPubMed

52.

Paul SB, Dhamija E, Gamanagatti SR, Sreenivas V, Yadav DP, Jain S, Shalimar, Acharya SK (2017) Evaluation of tumor response to intra-arterial chemoembolization of hepatocellular carcinoma: Comparison of contrast-enhanced ultrasound with multiphase computed tomography. Diagn Interv Imaging 98:253-260.https://doi.org/10.1016/j.diii.2016.09.002CrossRefPubMed

53.

Nam K, Stanczak M, Lyshchik A, Machado P, Kono Y, Forsberg F, Shaw CM, Eisenbrey JR (2018) Evaluation of Hepatocellular Carcinoma Transarterial Chemoembolization using Quantitative Analysis of 2D and 3D Real-time Contrast Enhanced Ultrasound. Biomed Phys Eng Express 4:035039. https://doi.org/10.1088/2057-1976/aabb14CrossRefPubMedPubMedCentral

54.

Moschouris H, Malagari K, Marinis A, Kornezos I, Stamatiou K, Nikas G, Papadaki MG, Gkoutzios P (2012) Hepatocellular carcinoma treated with transarterial chemoembolization: Evaluation with parametric contrast-enhanced ultrasonography. World J Radiol 4:379-86.https://doi.org/10.4329/wjr.v4.i8.379CrossRefPubMedPubMedCentral

55.

Oezdemir I, Wessner CE, Shaw C, Eisenbrey JR, Hoyt K (2020) Tumor Vascular Networks Depicted in Contrast-Enhanced Ultrasound Images as a Predictor for Transarterial Chemoembolization Treatment Response. Ultrasound Med Biol 46:2276-2286. https://doi.org/10.1016/j.ultrasmedbio.2020.05.010CrossRefPubMed

56.

Liu D, Liu F, Xie X, Su L, Liu M, Kuang M, Huang G, Wang Y, Zhou H, Wang K, Lin M, Tian J (2020) Accurate prediction of responses to transarterial chemoembolization for patients with hepatocellular carcinoma by using artificial intelligence in contrast-enhanced ultrasound. Eur Radiol 30:2365-2376. https://doi.org/10.1007/s00330-019-06553-6CrossRefPubMed

57.

Moschouris H, Malagari K, Kalokairinou M, Stamatiou K, Marinis A, Papadaki MG (2011) Contrast-enhanced ultrasonography with intraarterial administration of SonoVue for guidance of transarterial chemoembolization: an initial experience. Med Ultrason 13:296-301PubMed

58.

Lekht I, Nayyar M, Luu B, Guichet PL, Ho J, Ter-Oganesyan R, Katz M, Gulati M (2017) Intra-arterial contrast-enhanced ultrasound (IA CEUS) for localization of hepatocellular carcinoma (HCC) supply during transarterial chemoembolization (TACE): a case series. Abdom Radiol (NY) 42:1400-1407. https://doi.org/10.1007/s00261-016-1016-0CrossRef

59.

Shiozawa K, Watanabe M, Ikehara T, Yamamoto S, Matsui T, Saigusa Y, Igarashi Y, Maetani I (2018) Efficacy of intra-arterial contrast-enhanced ultrasonography during transarterial chemoembolization with drug-eluting beads for hepatocellular carcinoma. World J Hepatol 10:95-104.https://doi.org/10.4254/wjh.v10.i1.95CrossRefPubMedPubMedCentral

60.

Wessner CE, Shaw CM, Stanczak M, Forsberg F, Lyshchik A, Tan A, Eisenbrey JR (2020) Contrast-enhanced Ultrasound Identifies Patent Feeding Vessels in Transarterial Chemoembolization Patients With Residual Tumor Vascularity. Ultrasound Q 36:218-223.https://doi.org/10.1097/RUQ.0000000000000513CrossRefPubMedPubMedCentral

61.

Bruix J, Sherman M (2011) Management of hepatocellular carcinoma: an update. Hepatology 53:1020-2.https://doi.org/10.1002/hep.24199CrossRefPubMed

62.

Memon K, Lewandowski RJ, Kulik L, Riaz A, Mulcahy MF, Salem R (2011) Radioembolization for primary and metastatic liver cancer. Semin Radiat Oncol 21:294-302. https://doi.org/10.1016/j.semradonc.2011.05.004CrossRefPubMedPubMedCentral

63.

Hickey R, Lewandowski R, Salem R (2015) Yttrium-90 radioembolization is a viable treatment option for unresectable, chemorefractory colorectal cancer liver metastases: further evidence in support of a new treatment paradigm. Ann Surg Oncol 22:706-7.https://doi.org/10.1245/s10434-014-4165-9CrossRefPubMed

64.

Paul SB, Sharma H (2014) Role of Transcatheter Intra-arterial Therapies for Hepatocellular Carcinoma. J Clin Exp Hepatol 4:S112-21. https://doi.org/10.1016/j.jceh.2014.03.048CrossRefPubMedPubMedCentral

65.

Andreana L, Isgrò G, Marelli L, Davies N, Yu D, Navalkissoor S, Burroughs AK (2012) Treatment of hepatocellular carcinoma (HCC) by intra-arterial infusion of radio-emitter compounds: trans-arterial radio-embolisation of HCC. Cancer Treat Rev 38:641-9. https://doi.org/10.1016/j.ctrv.2011.11.004CrossRefPubMed

66.

Salem R, Lewandowski RJ, Kulik L, Wang E, Riaz A, Ryu RK, Sato KT, Gupta R, Nikolaidis P, Miller FH, Yaghmai V, Ibrahim SM, Senthilnathan S, Baker T, Gates VL, Atassi B, Newman S, Memon K, Chen R, Vogelzang RL, Nemcek AA, Resnick SA, Chrisman HB, Carr J, Omary RA, Abecassis M, Benson AB, 3rd, Mulcahy MF (2011) Radioembolization results in longer time-to-progression and reduced toxicity compared with chemoembolization in patients with hepatocellular carcinoma. Gastroenterology 140:497-507.e2.https://doi.org/10.1053/j.gastro.2010.10.049CrossRefPubMed

67.

Carr BI (2004) Hepatic arterial 90Yttrium glass microspheres (Therasphere) for unresectable hepatocellular carcinoma: interim safety and survival data on 65 patients. Liver Transpl 10:S107-10. https://doi.org/https://doi.org/10.1002/lt.20036CrossRefPubMed

68.

Kirchner T, Marquardt S, Werncke T, Kirstein MM, Brunkhorst T, Wacker F, Vogel A, Rodt T (2019) Comparison of health-related quality of life after transarterial chemoembolization and transarterial radioembolization in patients with unresectable hepatocellular carcinoma. Abdom Radiol (NY) 44:1554-1561. https://doi.org/10.1007/s00261-018-1802-yCrossRef

69.

Lewandowski RJ, Gabr A, Abouchaleh N, Ali R, Al Asadi A, Mora RA, Kulik L, Ganger D, Desai K, Thornburg B, Mouli S, Hickey R, Caicedo JC, Abecassis M, Riaz A, Salem R (2018) Radiation Segmentectomy: Potential Curative Therapy for Early Hepatocellular Carcinoma. Radiology 287:1050-1058. https://doi.org/10.1148/radiol.2018171768CrossRefPubMed

70.

Arndt L, Villalobos A, Wagstaff W, Cheng B, Xing M, Ermentrout RM, Bercu Z, Cristescu M, Shah A, Wedd J, Majdalany BS, Magliocca JF, Sellers MT, Kokabi N (2020) Evaluation of Medium-Term Efficacy of Y90 Radiation Segmentectomy vs Percutaneous Microwave Ablation in Patients with Solitary Surgically Unresectable < 4 cm Hepatocellular Carcinoma: A Propensity Score Matched Study. Cardiovasc Intervent Radiol

71.

Venkatanarasimha N, Gogna A, Tong KTA, Damodharan K, Chow PKH, Lo RHG, Chandramohan S (2017) Radioembolisation of hepatocellular carcinoma: a primer. Clin Radiol 72:1002-1013. https://doi.org/10.1016/j.crad.2017.07.021CrossRefPubMed

72.

Aslam A, Do RKG, Chernyak V, Mediratta-Lala M (2020) LI-RADS imaging criteria for HCC diagnosis and treatment: emerging evidence. Curr Hepatlogy 19:437-447. https://doi.org/10.1007/s11901-020-00546-6CrossRef

73.

Seyal AR, Gonzalez-Guindalini FD, Arslanoglu A, Harmath CB, Lewandowski RJ, Salem R, Yaghmai V (2015) Reproducibility of mRECIST in assessing response to transarterial radioembolization therapy in hepatocellular carcinoma. Hepatology 62:1111-21. https://doi.org/10.1002/hep.27915CrossRefPubMed

74.

Eisenbrey JR, Forsberg F, Wessner CE, Delaney LJ, Bradigan K, Gummadi S, Tantawi M, Lyshchik A, O'Kane P, Liu JB, Intenzo C, Civan J, Maley W, Keith SW, Anton K, Tan A, Smolock A, Shamimi-Noori S, Shaw CM (2020) US-triggered Microbubble Destruction for Augmenting Hepatocellular Carcinoma Response to Transarterial Radioembolization: A Randomized Pilot Clinical Trial. Radiology:202321. https://doi.org/10.1148/radiol.2020202321

75.

Delaney LJ, Forsberg F, Wessner CE, Machado P, Lyshchik A, O’Kane P, Gummadi S, Tan A, Shaw CM, Eisenbrey JR (2019) Predicting long term HCC response to radioembolization using contrast-enhanced ultrasound 1–2 weeks post treatment. IEEE INTERNATIONAL ULTRASONICS SYMPOSIUM (IUS). Glasgow, United Kingdom, pp 2129–2132. https://doi.org/10.1109/ULTSYM.2019.8926264

76.

Meloni MF, Goldberg SN, Livraghi T, Calliada F, Ricci P, Rossi M, Pallavicini D, Campani R (2001) Hepatocellular carcinoma treated with radiofrequency ablation: comparison of pulse inversion contrast-enhanced harmonic sonography, contrast-enhanced power Doppler sonography, and helical CT. AJR Am J Roentgenol 177:375-80. https://doi.org/10.2214/ajr.177.2.1770375CrossRefPubMed

77.

Choi D, Lim HK, Lee WJ, Kim SH, Kim YH, Lim JH (2003) Early assessment of the therapeutic response to radio frequency ablation for hepatocellular carcinoma: utility of gray scale harmonic ultrasonography with a microbubble contrast agent. J Ultrasound Med 22:1163-72.https://doi.org/10.7863/jum.2003.22.11.1163CrossRefPubMed

78.

Wen YL, Kudo M, Zheng RQ, Minami Y, Chung H, Suetomi Y, Onda H, Kitano M, Kawasaki T, Maekawa K (2003) Radiofrequency ablation of hepatocellular carcinoma: therapeutic response using contrast-enhanced coded phase-inversion harmonic sonography. AJR Am J Roentgenol 181:57-63. https://doi.org/10.2214/ajr.181.1.1810057CrossRefPubMed

79.

Kim CK, Choi D, Lim HK, Kim SH, Lee WJ, Kim MJ, Lee JY, Jeon YH, Lee J, Lee SJ, Lim JH (2005) Therapeutic response assessment of percutaneous radiofrequency ablation for hepatocellular carcinoma: utility of contrast-enhanced agent detection imaging. Eur J Radiol 56:66-73. https://doi.org/10.1016/j.ejrad.2005.03.023CrossRefPubMed

80.

Dill-Macky MJ, Asch M, Burns P, Wilson S (2006) Radiofrequency ablation of hepatocellular carcinoma: predicting success using contrast-enhanced sonography. AJR Am J Roentgenol 186:S287-95. https://doi.org/10.2214/AJR.04.1916CrossRefPubMed

81.

Lu MD, Yu XL, Li AH, Jiang TA, Chen MH, Zhao BZ, Zhou XD, Wang JR (2007) Comparison of contrast enhanced ultrasound and contrast enhanced CT or MRI in monitoring percutaneous thermal ablation procedure in patients with hepatocellular carcinoma: a multi-center study in China. Ultrasound Med Biol 33:1736-49. https://doi.org/10.1016/j.ultrasmedbio.2007.05.004CrossRefPubMed

82.

Salvaggio G, Campisi A, Lo Greco V, Cannella I, Meloni MF, Caruso G (2010) Evaluation of posttreatment response of hepatocellular carcinoma: comparison of ultrasonography with second-generation ultrasound contrast agent and multidetector CT. Abdom Imaging 35:447-53. https://doi.org/10.1007/s00261-009-9551-6CrossRefPubMed

83.

Bo XW, Xu HX, Sun LP, Zheng SG, Guo LH, Lu F, Wu J, Xu XH (2014) Bipolar radiofrequency ablation for liver tumors: comparison of contrast-enhanced ultrasound with contrast-enhanced MRI/CT in the posttreatment imaging evaluation. Int J Clin Exp Pathol 7:6108-16PubMedPubMedCentral

Title: Contrast-enhanced ultrasound (CEUS) in HCC diagnosis and assessment of tumor response to locoregional therapies
Authors: John R. Eisenbrey
Helena Gabriel
Esika Savsani
Andrej Lyshchik
Publication date: 01-08-2021
Publisher: Springer US
Keywords: Ultrasound
Hepatocellular Carcinoma
Hepatocellular Carcinoma
Ultrasound
Published in: Abdominal Radiology / Issue 8/2021
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI: https://doi.org/10.1007/s00261-021-03059-y

ACC 2024 Congress Coverage

Heart Failure Video

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Contrast-enhanced ultrasound (CEUS) in HCC diagnosis and assessment of tumor response to locoregional therapies

Abstract

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 8/2021

Can procedure time for paracentesis be optimized based on bottle selection?

Radiomics-based model using gadoxetic acid disodium-enhanced MR images: associations with recurrence-free survival of patients with hepatocellular carcinoma treated by surgical resection

Radioembolization versus portal vein embolization for contralateral liver lobe hypertrophy: effect of cirrhosis

Artificial intelligence in assessment of hepatocellular carcinoma treatment response

Preoperative evaluation of extramural venous invasion in rectal cancer using radiomics analysis of relaxation maps from synthetic MRI

A nomogram for predicting pancreatic mucinous cystic neoplasm and serous cystic neoplasm

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page