EVALUATION OF EFFECT OF TREATMENT FOR INVASIVE BLADDER-CANCER BY ULTRASONOGRAPHY WITH INTRAARTERIAL INFUSION OF CARBON-DIOXIDE MICROBUBBLES

RATIONALE AND OBJECTIVES. The purpose of this study was to evaluate th e diagnostic usefulness of the ultrasonography with intra-arterial inf usion of carbon dioxide micro-bubbles (CO2) for invasive bladder cance r. METHODS. Twelve patients with muscle-invading bladder cancer who we re treated by concurrent radiotherapy and intra-arterial infusion of d aily low dose of cisplatin using an implanted infusion port were inclu ded. A total of 30 studies was performed during the treatment to evalu ate the visualization of the tumor and effect of the treatment compare d with conventional ultrasonography, computed tomography, or cystoscop y. RESULTS. Satisfactory visualization of the tumor in CO2 ultrasonogr aphy was obtained in all patients, in particular in those with flat tu mor or prostatic invasion. The enhancement effect of CO2 on the tumor, which was maintained well in the late period of the treatment, made p ossible evaluation of the therapeutic effect. With respect to the eval uation of local response, disagreement between clinical response and t he evaluation of CO2 ultrasonography was observed in two patients with definite differentiation between wall edema and residual tumor after treatment being difficult. CONCLUSIONS. Carbon dioxide ultrasonography is easy to perform in patients treated with arterial infusion therapy using an implanted infusion port and provides practical information i n evaluating therapeutic effect.