Power Doppler sonography: Evaluation of hepatocellular carcinoma after treatment with transarterial embolization or percutaneous ethanol injection therapy

OBJECTIVE. The aim of this study was to compare tumor detectability by asse ssing the vascularity on power and color Doppler sonography and CT after tr ansarterial embolization or percutaneous ethanol injection therapy or both in hepatocellular carcinoma. SUBJECTS AND METHODS. Forty-seven nodules of hepatocellular carcinoma (size , 28 +/- 7 mm [mean +/- standard deviation]; range, 20-40 mm) in 38 patient s were treated with transarterial embolization (n = 6), percutaneous ethano l injection therapy (n = 23), and transarterial embolization plus percutane ous ethanol injection therapy (n = 9). Power Doppler sonography, color Dopp ler sonography, and CT were performed before and 2 weeks, 3 months, and 6 m onths after the treatments. The existence of hepatocellular carcinoma was c onfirmed by positive findings for color signals on both Doppler sonography techniques and for tumor stains on CT. All the tumors were determined to be malignant by microscopic examination of biopsy specimens. RESULTS. Before the treatments, power Doppler sonography (100%) and CT (100 %) were significantly more effective than color Doppler sonography (61.7%) (p < 0.001, for both). Six months after the treatments, the sensitivity of power Doppler sonography (87.5%) was significantly better than that of colo r Doppler sonography (12.5%) but was not significant in comparison with CT (66.6%). However, power Doppler sonography detected color signals in two of three tumors in which iodized oil was accumulated and no tumor stain appea red on CT, and the two lesions detected with power Doppler sonography were carcinomas. CONCLUSION. Power Doppler sonography can be considered the most sensitive t echnique in assessing the viability of hepatocellular carcinoma treated wit h transarterial embolization or percutaneous ethanol injection therapy or b oth.