Wobser, Hella; Wiest, Reiner; Salzberger, Bernd; Wohlgemuth, Walter Alexander; Stroszczynski, Christian; 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. IOS Press 10.3233/CH-141830
Full text not available from this repository. (Request a copy)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: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Gastroenterology |
UniBE Contributor: |
Wiest, Reiner |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1386-0291 |
Publisher: |
IOS Press |
Language: |
English |
Submitter: |
Lilian Karin Smith-Wirth |
Date Deposited: |
21 Apr 2015 16:07 |
Last Modified: |
05 Dec 2022 14:45 |
Publisher DOI: |
10.3233/CH-141830 |
PubMed ID: |
24577382 |
Uncontrolled Keywords: |
CEUS; HCC; Real-time image fusion; TACE; treatment response |
URI: |
https://boris.unibe.ch/id/eprint/67065 |
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