Nonsurgical treatment of hepatocellular carcinoma (HCC) includes transcatheter arterial embolization (TAE) and percutaneous therapy, such as percutaneous ethanol injection (PEI) therapy. Accuracy in assessing treatment response is essential for determining the necessity of additional therapy to complete the treatment. Contrast-enhanced computerized tomography (CT) and magnetic resonance (MRI), angiography, Doppler ultrasonography (US), and contrast-enhanced ultrasonography (CEUS) have been applied to evaluate treatment response [1,2].After successful treatment, tumor enhancement disappears at contrast-enhanced CT and angiography, or intratumoral flow signal disappears at color or power Doppler US. Color...

PATIENTSSeventy three patients with HCC, 60 men and 13 women (age range, 29-83 years old; mean age, 60) were included in the patient population. These patients had 188 nodules ranging from 0.7 to 15.5 cm diameter (average 3.8 cm).Everyindividual were undergone ultrasound scan. Initial scans were obtained with harmonic imaging. All subsequent scans were obtained with contrast-specific imaging modes(harmonic and pulseinversion imaging, at low mechanical index), after intravenous (peripheral veins) injection of a microbubble contrast agent (CEUS) (second generation).Contrast enhancedUS was performed continuously for 5...

CEUS showed statistically significant agreement with the so called gold-standard (Table 1). CT scans were not able to show accurate results in patients treated by arterial chemoembolization.Gold-standard methods showed that 98 lesions (52%) were completely treated.In this study, 2 false-positive lesions were found, compared with contrast-enhanced dynamic MRI. Also, 2 false-negative nodules were found. Compared with MRI, the sensitivity was 91.3% (21 of 23) and the specificity was 71.4% (5 of 7) (Table 2).Compared with CECT, 7 false-positive and 11 false-negative nodules were found. The...

CEUS is safe, easy to perform, low cost, portable and offers real-time scanning. This technique is also helpful for US-guided retreatment of residual viable tumor owing to its real-time character.This study supports that CEUS provides useful information as to whether or not additional therapy is necessary.Follow-up study results or histologic evidence, or even both could be useful to confirm our results.In conclusion, we assume that CEUS can be useful in following-up non-surgical liver lesions treatments and can also provide a new method for assessing therapeutic...

1 Bartolozzi C, Lencioni R, Caramella D, Falaschi F, Cioni R, DiCoscio G. Hepatocellular carcinoma: CT and MR features after transcatheter arterial embolization and percutaneous ethanol injection. Radiology 1994; 191:123–128.2 Lencioni R, Caramella D, Bartolozzi C. Hepatocellular carcinoma: use of color Doppler US to evaluate response to treatment with percutaneous ethanol injection. Radiology 1995; 194:113–118.3 Tanaka K, Inoue S, Numata K, et al. Color Doppler sonography of hepatocelular carcinoma before and after treatment by transcatheter arterial embolization. AJR Am J Roentgenol 1992; 158:541–546.4 Hayashi M,...

Maria Cristina [email protected] das Clínicas da Faculdade de Medicina daUniversidade de São Paulo - Brazil