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© 2006 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 25:477-486 • 0278-4297

Assessment of the Therapeutic Response of Hepatocellular Carcinoma Treated With Transcatheter Arterial Chemoembolization

Comparison of Contrast-Enhanced Sonography and 3-Phase Computed Tomography

Hyun Jin Kim, MD, Tae Kyoung Kim, MD, Pyo Nyun Kim, MD, Ah Young Kim, MD, Eun Young Ko, MD, Kyoung Won Kim, MD, Kyu-Bo Sung, MD, Hyun Kwon Ha, MD, Hyun Cheol Kim, MD and Moon-Gyu Lee, MD

Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (H.J.K., T.K.K., P.N.K., A.Y.K., E.Y.K., K.W.K., K.-B.S., H.K.H., H.C.K., M.-G.L.); Department of Radiology, St Vincent’s Hospital, Suwon, Korea (H.J.K.); and Department of Medical Imaging, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada (T.K.K.).

Address correspondence to Tae Kyoung Kim, MD, Department of Medical Imaging, Toronto General Hospital, University of Toronto, 585 University Ave, Toronto, Ontario M5G 2N2, Canada. E-mail: taekyoung.kim{at}uhn.on.ca

Objective. The purpose of this study was to compare contrast-enhanced sonography with 3-phase computed tomography (CT) in assessing the therapeutic response of hepatocellular carcinomas (HCCs) treated with transcatheter arterial chemoembolization (TACE). Methods. Twenty-nine nodular HCCs treated with TACE were examined with contrast-enhanced sonography, 3-phase helical CT, and conventional angiography. Contrast-enhanced sonographic and CT findings were interpreted separately and prospectively for the presence or absence of contrast enhancement in the treated HCCs. Conventional angiography served as the reference standard. Results. Intratumoral enhancement was seen in 19 HCCs (61%) on contrast-enhanced sonography and 12 HCCs (39%) on CT. Enhancement patterns on sonography were blush in 8 (42%), branching in 2 (11%), nodular in 4 (21%), and stippled in 5 (26%). Of the 19 HCCs with intratumoral enhancement on contrast-enhanced sonography, 13 (68%) showed tumor staining on angiography. Of the 12 HCCs without intratumoral enhancement on sonography, 1 (8%) showed tumor staining on angiography. The sensitivity and specificity of contrast-enhanced sonography in depicting flow in HCCs treated with TACE were 93% and 65%, respectively. The sensitivity and specificity of 3-phase CT were 64% and 100%. Conclusions. Contrast-enhanced sonography is a more sensitive imaging method than 3-phase CT in depicting vascularity in HCCs treated with TACE.

Key Words: contrast media • liver neoplasm, sonography • liver neoplasm, blood supply • sonography, contrast media

Abbreviations: CT, computed tomography • HCC, hepatocellular carcinoma • TACE, transcatheter arterial chemoembolization




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[Abstract] [Full Text] [PDF]


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