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CEUS in Treatment Response Evaluation: Liver Embolization
John Eisenbrey, PhD
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KEY FACTS

  • Terminology

    • Imaging

      TERMINOLOGY

      • Abbreviations

        • Transarterial chemoembolization (TACE)
        • Transarterial radioembolization (TARE)
      • Definitions

        • Transarterial embolization therapies can be used as palliative treatments or as bridge to transplant and rely on localized, catheter-based delivery of embolic or therapeutic material to tumors within liver via hepatic arteries
        • TACE involves localized injection of chemotherapeutic drugs mixed with Lipiodol or drug-eluting beads containing doxorubicin (DEB-DOX)
        • TARE involves localized placement of glass microspheres embedded with Y-90, providing focal therapeutic radiation source within tumor

      CEUS TECHNIQUE

      • CEUS Protocol Advice

        IMAGING

        • General Features

          • CT/MR Findings

            • US Findings

              • CEUS Findings

                • Technical Pitfalls and Challenges

                  Clinical Issues

                  • Treatment and Follow-Up

                    Selected References

                    1. Gummadi S et al: Contrast-enhanced ultrasonography in interventional oncology. Abdom Radiol (NY). ePub, 2018
                    2. Gummadi S et al: Contrast-enhanced ultrasound identifies early extrahepatic collateral contributing to residual hepatocellular tumor viability after transarterial chemoembolization. Radiol Case Rep. 13(3):713-718, 2018
                    3. Nam K et al: Evaluation of Hepatocellular Carcinoma Transarterial Chemoembolization using Quantitative Analysis of 2D and 3D Real-time Contrast Enhanced Ultrasound. Biomed Phys Eng Express. 4(3):035039, 2018
                    4. Shaw CM et al: Contrast-enhanced ultrasound evaluation of residual blood flow to hepatocellular carcinoma after treatment with transarterial chemoembolization using drug-eluting beads: a prospective study. J Ultrasound Med. 34(5):859-67, 2015
                    5. Barr RG: Off-label use of ultrasound contrast agents for abdominal imaging in the United States. J Ultrasound Med. 32(1):7-12, 2013
                    6. Claudon M et al: Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS) in the liver - update 2012: a WFUMB-EFSUMB initiative in cooperation with representatives of AFSUMB, AIUM, ASUM, FLAUS and ICUS. Ultrasound Med Biol. 39(2):187-210, 2013
                    7. Takizawa K et al: Use of contrast-enhanced ultrasonography with a perflubutane-based contrast agent performed one day after transarterial chemoembolization for the early assessment of residual viable hepatocellular carcinoma. Eur J Radiol. 82(9):1471-80, 2013
                    8. Brown DB et al: Quality improvement guidelines for transhepatic arterial chemoembolization, embolization, and chemotherapeutic infusion for hepatic malignancy. J Vasc Interv Radiol. 23(3):287-94, 2012
                    9. Xu HX et al: Treatment response evaluation with three-dimensional contrast-enhanced ultrasound for liver cancer after local therapies. Eur J Radiol. 76(1):81-8, 2010
                    10. Kono Y et al: Contrast-enhanced ultrasound as a predictor of treatment efficacy within 2 weeks after transarterial chemoembolization of hepatocellular carcinoma. J Vasc Interv Radiol. 18(1 Pt 1):57-65, 2007
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                    References
                    Tables

                    Tables

                    KEY FACTS

                    • Terminology

                      • Imaging

                        TERMINOLOGY

                        • Abbreviations

                          • Transarterial chemoembolization (TACE)
                          • Transarterial radioembolization (TARE)
                        • Definitions

                          • Transarterial embolization therapies can be used as palliative treatments or as bridge to transplant and rely on localized, catheter-based delivery of embolic or therapeutic material to tumors within liver via hepatic arteries
                          • TACE involves localized injection of chemotherapeutic drugs mixed with Lipiodol or drug-eluting beads containing doxorubicin (DEB-DOX)
                          • TARE involves localized placement of glass microspheres embedded with Y-90, providing focal therapeutic radiation source within tumor

                        CEUS TECHNIQUE

                        • CEUS Protocol Advice

                          IMAGING

                          • General Features

                            • CT/MR Findings

                              • US Findings

                                • CEUS Findings

                                  • Technical Pitfalls and Challenges

                                    Clinical Issues

                                    • Treatment and Follow-Up

                                      Selected References

                                      1. Gummadi S et al: Contrast-enhanced ultrasonography in interventional oncology. Abdom Radiol (NY). ePub, 2018
                                      2. Gummadi S et al: Contrast-enhanced ultrasound identifies early extrahepatic collateral contributing to residual hepatocellular tumor viability after transarterial chemoembolization. Radiol Case Rep. 13(3):713-718, 2018
                                      3. Nam K et al: Evaluation of Hepatocellular Carcinoma Transarterial Chemoembolization using Quantitative Analysis of 2D and 3D Real-time Contrast Enhanced Ultrasound. Biomed Phys Eng Express. 4(3):035039, 2018
                                      4. Shaw CM et al: Contrast-enhanced ultrasound evaluation of residual blood flow to hepatocellular carcinoma after treatment with transarterial chemoembolization using drug-eluting beads: a prospective study. J Ultrasound Med. 34(5):859-67, 2015
                                      5. Barr RG: Off-label use of ultrasound contrast agents for abdominal imaging in the United States. J Ultrasound Med. 32(1):7-12, 2013
                                      6. Claudon M et al: Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS) in the liver - update 2012: a WFUMB-EFSUMB initiative in cooperation with representatives of AFSUMB, AIUM, ASUM, FLAUS and ICUS. Ultrasound Med Biol. 39(2):187-210, 2013
                                      7. Takizawa K et al: Use of contrast-enhanced ultrasonography with a perflubutane-based contrast agent performed one day after transarterial chemoembolization for the early assessment of residual viable hepatocellular carcinoma. Eur J Radiol. 82(9):1471-80, 2013
                                      8. Brown DB et al: Quality improvement guidelines for transhepatic arterial chemoembolization, embolization, and chemotherapeutic infusion for hepatic malignancy. J Vasc Interv Radiol. 23(3):287-94, 2012
                                      9. Xu HX et al: Treatment response evaluation with three-dimensional contrast-enhanced ultrasound for liver cancer after local therapies. Eur J Radiol. 76(1):81-8, 2010
                                      10. Kono Y et al: Contrast-enhanced ultrasound as a predictor of treatment efficacy within 2 weeks after transarterial chemoembolization of hepatocellular carcinoma. J Vasc Interv Radiol. 18(1 Pt 1):57-65, 2007