Therapeutic effect of transcatheter arterial chemoembolization on hepatocellular carcinoma: evaluation with contrast-enhanced harmonic power Doppler ultrasound

The aim of this study was to investigate the usefulness of contrast-enhance d harmonic power Doppler ultrasound (US) for the detection of residual viab le hepatocellular carcinoma (HCC) after treatment with transcatheter arteri al chemoembolization (TACE). Forty-seven patients with 68 HCC lesions 1.8-9 .5 cm in diameter (mean +/-D 4.3 +/- 1.7 cm) underwent contrast-enhanced po wer Doppler US, in the harmonic mode, before and after treatment with TACE. Unenhanced spiral CT and contrast-enhanced dynamic MR imaging were also pe rformed to help establish the outcome of therapy. Before treatment, intratu moral blood flow signals were detected at contrast-enhanced harmonic power Doppler US in 65 (95 %) of 68 lesions. After TACE, flow signals were no lon ger detectable in 22 of these 65 lesions, which showed complete response at spiral CT and dynamic MR imaging. In 38 (88 %) of the 43 lesions with part ial response, intratumoral flow signals were still identified at contrast-e nhanced harmonic power Doppler US. Twenty-eight of these 38 lesions underwe nt additional treatment with percutaneous ethanol injection (PEI) using con trast-enhanced harmonic power Doppler US guidance. Complete response was se en after PEI in 23 of 28 lesions. Contrast-enhanced harmonic power Doppler US proved useful for assessing the therapeutic effect of TACE on HCC and fo r guiding additional treatment with PEI in cases of partial response.