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Evaluation of treatment response after chemoembolisation (TACE) in hepatocellular carcinoma using real time image fusion of contrast-enhanced ultrasound (CEUS) and computed tomography (CT) - Preliminary results.
- Source :
- Clinical Hemorheology & Microcirculation; 2014, Vol. 57 Issue 2, p191-201, 11p
- Publication Year :
- 2014
-
Abstract
- OBJECTIVE: To evaluate treatment response of hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE) with a new real-time imaging fusion technique of contrast-enhanced ultrasound (CEUS) with multi-slice detection computed tomography (CT) in comparison to conventional post-interventional follow-up. MATERIAL AND METHODS: 40 patients with HCC (26 male, ages 46-81 years) were evaluated 24 hours after TACE using CEUS with ultrasound volume navigation and image fusion with CT compared to non-enhanced CT and follow-up contrast-enhanced CT after 6-8 weeks. Reduction of tumor vascularization to less than 25% was regarded as 'successful' treatment, whereas reduction to levels >25% was considered as 'partial' treatment response. Homogenous lipiodol retention was regarded as successful treatment in non-enhanced CT. RESULTS: Post-interventional image fusion of CEUS with CT was feasible in all 40 patients. In 24 patients (24/40), post-interventional image fusion with CEUS revealed residual tumor vascularity, that was confirmed by contrast-enhanced CT 6-8 weeks later in 24/24 patients. In 16 patients (16/40), post-interventional image fusion with CEUS demonstrated successful treatment, but follow-up CT detected residual viable tumor (6/16). Non-enhanced CT did not identify any case of treatment failure. Image fusion with CEUS assessed treatment efficacy with a specificity of 100%, sensitivity of 80% and a positive predictive value of 1 (negative predictive value 0.63). CONCLUSIONS: Image fusion of CEUS with CT allows a reliable, highly specific post-interventional evaluation of embolization response with good sensitivity without any further radiation exposure. It can detect residual viable tumor at early state, resulting in a close patient monitoring or re-therapy. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 13860291
- Volume :
- 57
- Issue :
- 2
- Database :
- Complementary Index
- Journal :
- Clinical Hemorheology & Microcirculation
- Publication Type :
- Academic Journal
- Accession number :
- 97227764
- Full Text :
- https://doi.org/10.3233/CH-141830