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Abstract
In vitro and in vivo studies have identified that low-frequency ultrasound (US) and microbubbles (MBs) mediate tumor inhibitory effects. However, the application of US in the clinical setting remains unclear. The aim of the present study was to investigate the clinically therapeutic effect of 20 kHz US in combination with MBs for the treatment of hepatic carcinoma. A 71-year-old male with a hepatic malignant tumor was admitted to Nantong University Affiliated Nantong Tumor Hospital (Nantong, China). The patient was subsequently sonicated with 20 kHz US and MBs over a period of five days. The low-frequency US parameters were set at 20 kHz, 2 W/cm2, duty cycle 40% (on 2 sec, off 3 sec) for a duration of 5 min each day for a total of five days. Computed tomography (CT), contrast-enhanced US (CEUS) and carbohydrate antigen 19-9 (CA19-9) tests were performed to evaluate the therapeutic effects. Although the tumor size increased marginally on CT from 5.4 to 5.6 cm after US treatment, the intensity and enhanced-areas on the CT scans and CEUS decreased. The abdominal lymph node decreased in size, from 2.2 to 1.9 cm, and CA19-9 levels decreased from the pretreatment value of 2,007 to 734 U/ml. Therapy with low-frequency US combined with MBs may exhibit an antivasculature effect and may be used as a palliative treatment for patients with unresectable hepatic malignant tumors.
Highlights
Ultrasound (US) is a diagnostic tool used clinically, this technique is used therapeutically
US therapy has been clinically investigated as a tumor treatment with a particular focus on the thermal effects generated by high‐intensity focused US [1]
Our previous findings indicated that low‐intensity US with microbubbles (MBs) may exhibit anti‐angiogenic effects on subcutaneous tumors in nude mice [14,15]
Summary
Prior to and following US treatment, CEUS and CT imaging, as well as the examination of CA19‐9 levels, were used to evaluate the therapeutic effect. Laboratory tests, imaging data, US treatment and results were obtained from the patient's medical records. The ultrasonic instrument (iU22 US system; Philips Medical Systems, Bothell, WA, USA) was used to identify the hepatic tumor. CEUS images of the tumor were captured by an experienced examiner using the iU22 US system (Philips Medical Systems). Following injection of the bolus, the real‐time enhancement pattern of the contrast agent was observed inside the tumor for 3‐5 min and an imaging video was captured. After treatment with US and MBs, the intensity and enhanced‐areas on the CEUS and the CT images were reduced
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