Role of ultrasonography for monitoring tumor necrosis after chemotherapy.

Abstract

Ultrasonography for monitoring the response of malignant liver lesions to regional therapy offers several advantages. The instrument is easy to transport and can be used in intensive care units, so it is the procedure of choice within the first few days after invasive techniques, such as isolated liver perfusion, to demonstrate tumor response. Changes in size or in the sonomorphological pattern of liver lesions early after therapy indicate a therapeutic response. There are no data available on the sensitivity of ultrasonography for differentiating the necrotic and viable parts of the tumor. If information on the extent of tumor necrosis is crucial for decisions on further treatment of a patient, ultrasonography should be complemented with other techniques, such as fine-needle puncture or imaging techniques such as computed tomography, nuclear magnetic resonance, and single photon emission computed tomography. The contribution of more recent developments in ultrasonography, such as color Doppler analysis of intratumoral blood flow or three-dimensional ultrasonography, for monitoring tumor necrosis remains to be evaluated.