Hepatocellular Carcinoma: Therapeutic Experience With Percutaneous Ethanol Injection Under Real-time Contrast-Enhanced Color Doppler Sonography With the Contrast Agent Levovist

• Published in: Journal of ultrasound in medicine Vol. 21; no. 9; pp. 1015 - 1022
• Main Authors: Shirato, Kazuhito, Morimoto, Manabu, Tomita, Naohiko, Kokawa, Atsushi, Sugimori, Kazuya, Saito, Toshifumi, Numata, Kazushi, Sekihara, Hisahiko, Tanaka, Katsuaki
• Format: Journal Article
• Language: English
• Published: Laurel, MD Am inst Ulrrasound Med 01.09.2002; American Institute of Ultrasound in Medicine
• Subjects: Aged; Biological and medical sciences; Carcinoma, Hepatocellular - diagnostic imaging; Carcinoma, Hepatocellular - drug therapy; Contrast Media; Ethanol - administration & dosage; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Image Enhancement; Infusions, Intra-Arterial; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - drug therapy; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Middle Aged; Polysaccharides; Prospective Studies; Tumors; Ultrasonography, Doppler, Color; Antineoplastic agent; Sonography; Human; Description; Ethanol; Hepatic disease; Hepatocellular carcinoma; Malignant tumor; Injection; Duplex ultrasonography; Real time; Percutaneous route; Treatment; Color echography; Digestive diseases; Medical imagery; Technique; Contrast media
• ISSN: 0278-4297; 1550-9613
• DOI: 10.7863/jum.2002.21.9.1015

To describe our experience with percutaneous ethanol injection under real-time contrast-enhanced color Doppler sonography with Levovist (SH U 508A; Nihon Schering, Osaka, Japan) for hepatocellular carcinoma after transcatheter arterial infusion. Twenty patients (17 men and 3 women; mean age, 58.4 years) with 23 hepatocellular carcinoma nodules (mean +/- SD, 2.7 +/- 1.5 cm) underwent percutaneous ethanol injection under real-time contrast-enhanced color Doppler sonography 1 week after transcatheter arterial infusion. Therapeutic effects were assessed by contrast-enhanced computed tomography and posttreatment fine-needle biopsy. This study was performed on a prospective basis. After the transcatheter arterial infusion, contrast-enhanced color Doppler sonography showed intense intratumoral color signals in all 23 hepatocellular carcinomas. After the percutaneous ethanol injection, contrast-enhanced color Doppler sonography, fine-needle biopsy, and contrast-enhanced computed tomography showed no color signals, no viable tumor tissues, and no enhancement in any of the 23 hepatocellular carcinomas. Three to 5 (mean, 3.3) percutaneous ethanol injection sessions with a 5.2- to 15.6-mL (mean, 12.8-mL) total volume of ethanol per tumor were required for complete disappearance of color signals on contrast-enhanced color Doppler sonography. Percutaneous ethanol injection under real-time contrast-enhanced color Doppler sonography has considerable efficacy in treating hepatocellular carcinoma.