Quantitative analysis of perfusion changes of hepatocellular carcinoma treated by transcatheter arterial chemoembolization using contrast enhanced ultrasound

doi:10.3877/cma.j.issn.1672-6448.2020.03.010

Abstract

Abstract:

Objective

To analyze the perfusion change of hepatocellular carcinoma (HCC) treated by transcatheter arterial chemoembolization (TACE) using parametric contrast enhanced ultrasound (CEUS), and to investigate the application value of parametric CEUS in TACE.

Methods

From August 2011 to March 2014, a total of 61 HCC patients (60 men and 1 women; age range: 18-76 years, mean age: 53 ± 13 years) who underwent one procedure of TACE were enrolled in this prospective study. All cases were scanned by CEUS 1-7 days before and after TACE (3 days, 15 days, and 30 days post-TACE). Then, tumor perfusion during the procedure of CEUS was analyzed with dedicated software. Time-intensity curves were plotted and parameters including rise time (RT), time to peak (TTP), maximum of intensity (IMAX), and mean transit time (mTT) were extracted.

Results

The IMAX and perfusion index (PI) pre-TACE were significantly higher than that those at 3 days post-TACE (all P<0.01). The PI at 3 days post-TACE was lower than that at 30 days post-TACE (P=0.009). According to the quantitative parameters at 15 days post-TACE, the IMAX and PI decreased at 3 days post-TACE, then increased a little at 15 days, and increased obviously at 30 days but was still lower than that pre-TACE.

Conclusion

The perfusion level of residual tumors after TACE is the lowest during 3-15 days post-TACE. CEUS provides a noninvasive tool to evaluate the perfusion change of HCC after TACE.

Key words: Parametric contrast-enhanced ultrasound, Transcatheter arterial chemoembolization, Hepatocellular carcinoma

Ming Liu, Ming Xu, Guangliang Huang, Luyao Zhou, Manxia Lin, Mingde Lyu, Xiaoyan Xie. Quantitative analysis of perfusion changes of hepatocellular carcinoma treated by transcatheter arterial chemoembolization using contrast enhanced ultrasound[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2020, 17(03): 262-267.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2020.03.010

https://chaosheng.cma-cmc.com.cn/EN/Y2020/V17/I03/262

Figures/Tables 4

References 12

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参数	术前	术后3 d	术后15 d	术后30 d
IMAX	320.49（153.83，783.34）	128.12（49.29，425.96）^a	208.45（57.11，348.04）	266.31（107.75，526.12）
PI	195.94（111.26，794.03）	120.91（31.57，561.55）^a	128.23（76.54，539.61）	348.78（87.87，827.02）^b

参数	术前	术后3 d	术后15 d	术后30 d
IMAX	320.49（153.83，783.34）	128.12（49.29，425.96）^a	208.45（57.11，348.04）	266.31（107.75，526.12）
PI	195.94（111.26，794.03）	120.91（31.57，561.55）^a	128.23（76.54，539.61）	348.78（87.87，827.02）^b

定量参数		术前	术后3 d	术后15 d	术后30 d
参考区		?	?	?	?
?	RT（s）	27.28±14.03（1.37~72.08）	21.03±8.71（5.85~42.43）	25.92±12.89（6.99~41.77）	27.09±11.05（7.27~56.88）
?	TTP（s）	35.40±20.57（1.80~133.65）	28.64±13.91（7.19 - 85.85）	34.88±19.46 （8.24 - 71.78）	35.30±13.77（12.72~68.98）
?	mTT（s）	130.32±123.71（3.12~478.57）	94.01±99.21 （19.47~433.05）	101.45±82.87 （20.28~287.82）	116.88±111.09（18.4~525.28）
分析区		?	?	?	?
?	RT（s）	15.18±8.24（1.89~44.33）	16.27±8.45 （2.78~55.31）	13.99±5.63 （5.75~22.04）	16.98±7.57（4.04~44.41）
?	TTP（s）	18.41±10.38（2.32~61.62）	20.00±9.77 （4.45~70.06）	17.25±6.60 （6.45~25.44）	22.24±12.27 （10.02~63.14）
?	mTT（s）	69.83±75.17（4.84~390.34）	76.12±86.62 （16.33~453.89）	52.38±46.86 （17.41~152.25）	73.47±97.51（12.65~529）

定量参数		术前	术后3 d	术后15 d	术后30 d
参考区		?	?	?	?
?	RT（s）	27.28±14.03（1.37~72.08）	21.03±8.71（5.85~42.43）	25.92±12.89（6.99~41.77）	27.09±11.05（7.27~56.88）
?	TTP（s）	35.40±20.57（1.80~133.65）	28.64±13.91（7.19 - 85.85）	34.88±19.46 （8.24 - 71.78）	35.30±13.77（12.72~68.98）
?	mTT（s）	130.32±123.71（3.12~478.57）	94.01±99.21 （19.47~433.05）	101.45±82.87 （20.28~287.82）	116.88±111.09（18.4~525.28）
分析区		?	?	?	?
?	RT（s）	15.18±8.24（1.89~44.33）	16.27±8.45 （2.78~55.31）	13.99±5.63 （5.75~22.04）	16.98±7.57（4.04~44.41）
?	TTP（s）	18.41±10.38（2.32~61.62）	20.00±9.77 （4.45~70.06）	17.25±6.60 （6.45~25.44）	22.24±12.27 （10.02~63.14）
?	mTT（s）	69.83±75.17（4.84~390.34）	76.12±86.62 （16.33~453.89）	52.38±46.86 （17.41~152.25）	73.47±97.51（12.65~529）

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