Contrast-Enhanced Ultrasonography for Assessment of Tumor Vascularity in Hepatocellular Carcinoma

Abstract

Studies have shown that angiogenesis is a critical factor for tumor growth and metastasis in a variety of human tumors. Although various methods have been tried to assess vessels in tumors, including microvessel density (MVD), assessment of tumor vessels by radiologic techniques is not well established. The aim of this study was to investigate the efficacy of contrast-enhanced ultrasonography (CEUS) in determining the tumor vascularity of hepatocellular carcinoma (HCC). Contrast-enhanced ultrasonography was done in 50 patients with HCC, which was shown histopathologically through subsequent hepatic resection. A contrast pulse sequencing technique and quantitative auto-tracking contrast quantification software were used to analyze the peak intensity (PI) of HCC. Immunohistochemistry was performed to evaluate the level of MVD in HCC. Then the relationship between PI and the level of MVD was analyzed. The mean PIs of HCC and peripheral tissue +/- SD were 135.19 +/- 28.16 and 72.91 +/- 19.22 dB, respectively. The MVDs of HCC and peripheral tissue were 43.44 +/- 12.22 and 17.14 +/- 9.18, respectively. The values of PI and MVD of HCC were significantly higher than those of peripheral tissue. A significant correlation was found between PI and MVD in HCC tissues (P < .05). The PI in CEUS could reflect the MVD in HCC. Therefore, quantification of CEUS seems to be helpful for assessment of tumor vascularity in HCC.