Wobser, Hella and Wiest, Reiner and Salzberger, Bernd and Wohlgemuth, Walter Alexander and Stroszczynski, Christian and Jung, Ernst-Michael (2014) 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. CLINICAL HEMORHEOLOGY AND MICROCIRCULATION, 57 (2). pp. 191-201. ISSN 1386-0291, 1875-8622
Full text not available from this repository. (Request a copy)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.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | DRUG-ELUTING BEADS; ARTERIAL CHEMOEMBOLIZATION; LOCOREGIONAL THERAPY; TUMOR RESPONSE; LIVER-LESIONS; SURVIVAL; EMBOLIZATION; CANCER; GUIDELINES; MANAGEMENT; Real-time image fusion; CEUS; HCC; TACE; treatment response |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin I |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 29 Nov 2019 08:49 |
| Last Modified: | 29 Nov 2019 08:49 |
| URI: | https://pred.uni-regensburg.de/id/eprint/10936 |
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