Power Doppler sonography assessment of tumor recurrence after chemoembolization therapy for hepatocellular carcinoma

OBJECTIVE, This study was undertaken to determine the value of power Dopple r sonography in the evaluation of recurrent hepatocellular carcinomas after transcatheter arterial chemoembolization therapy. SUBJECTS AND METHODS. Forty-five patients (age range, 45-81 years; mean age , 61 years) with hepatocellular carcinomas prospectively underwent power Do ppler sonography, helical CT, and intraarterial digital subtraction angiogr aphy before and after transcatheter arterial chemoembolization therapy to e valuate for tumor recurrence. Three to 6 months after transcatheter arteria l chemoembolization therapy, the Doppler signal; its location, and shape we re evaluated. The results were compared with tumor vascularity as determine d on helical CT and intraarterial digital subtraction angiography, which we re used as the gold standards (n = 142). RESULTS. A sonographic signal was seen in 80 of 142 lesions with power Dopp ler sonography. Flow signal in lesions tended to be more difficult to detec t in the left lobe (sensitivity, 74%) than in the right lobe (sensitivity, 93%). The location of the color signal was in the tumor's center, on its pe riphery, or both. No correlation between tumor recurrence and the location of a signal within a tumor was found. Power Doppler sonography had a sensit ivity of 87%, a specificity of 85%, and an accuracy of 86% in revealing tum or recurrence after transcatheter arterial chemoembolization therapy. All l esions that showed linear signals in the center or at the periphery of the tumors proved to be recurring tumors (n = 20). In lesions with spotty signa ls, tumor recurrence was not revealed in nine of 60 lesions. CONCLUSION. Power Doppler sonography can be used for follow-up studies afte r transcatheter arterial chemoembolization therapy as a sensitive and cost- effective imaging technique. Although spotty signals were frequently seen, linear signals appeared to be specific for tumor recurrence.