Use of Contrast-Enhanced Ultrasound with Sonazoid for Evaluating the Radiotherapy Efficacy for Hepatocellular Carcinoma.

Akihiro Funaoka,Yusuke Saigusa,Masayuki Nakano,Hiromi Nihonmatsu,Masahiro Okada,Makoto Chuma,Hiroyuki Fukuda,Shin Maeda,Atsuya Takeda,Yuichirou Tsurugai,Kazushi Numata

doi:10.3390/diagnostics11030486

Abstract

Radiotherapy is one of the available curative therapies for hepatocellular carcinoma (HCC). We investigate the use of contrast-enhanced ultrasound using Sonazoid (SCEUS) in evaluating the efficacy of radiotherapy for HCC. We enrolled 59 patients with 59 HCCs in this retrospective study. Tumor size and tumor vascularity were evaluated using SCEUS before and 1, 3, 7, 10, and 13 months after radiotherapy. The median follow-up period was 44.5 months (range: 16–82 months). Of the HCCs, 95% (56/59) had no local recurrence, while 5% (3/59) did. At 13 months after radiotherapy, in cases with no local recurrence, SCEUS showed a reduction in tumor vascularity in all cases, while tumor size reduction (>30% reduction, compared with pre-radiotherapy) was observed in 82.1% (46/56). In all three cases of local recurrence, vascularity and tumor size reduction were not observed during the follow-up period and residual HCCs were demonstrated pathologically. Compared with cases with local recurrence, tumor size reduction and reduction in tumor vascularity (p < 0.001) were significantly greater in cases with no local recurrence at 13 months after radiotherapy. SCEUS may be useful in evaluating radiotherapy efficacy for HCC.

Highlights

The global incidence of primary liver cancer is 841,080 people, accounting for 4.7% of all cancers [1,2]
We investigate the use of contrast-enhanced ultrasound (CEUS) with Sonazoid (SCEUS) for evaluating RT efficacy for Hepatocellular carcinoma (HCC) with a follow-up period of at least 13 months
stereotactic body radiotherapy (SBRT) was administered to 48 cases and hypofractionated radiotherapy (HFRT) was administered to 11

Summary

Introduction

The global incidence of primary liver cancer is 841,080 people, accounting for 4.7% of all cancers [1,2]. Hepatocellular carcinoma (HCC) accounts for 75 to 85% of all primary liver cancers [1], and HCC incidence continues to increase [3]. The HCC treatment options vary, depending on the prognostic stage; surgical resection, liver transplantation, and radiofrequency ablation (RFA) are the only curative treatments [4,5,6]. Radiotherapy (RT), such as stereotactic body radiotherapy (SBRT), has become widely used in clinical practice as a second-line treatment option, especially in patients ineligible for surgical resection or liver transplantation, or those for whom loco-regional therapies, such as RFA or transarterial chemoembolization, have failed [7,8,9]. RT appears to be an acceptable alternative treatment option for patients who are not candidates for RFA [10,11]

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Conclusion