Pilot study evaluating catheter-directed contrast-enhanced ultrasound compared to catheter-directed computed tomography arteriography as adjuncts to digital subtraction angiography to guide transarterial chemoembolization

• Published in: Clinical radiology Vol. 69; no. 10; pp. 1056 - 1061
• Main Authors: Burgmans, M.C, van Erkel, A.R, Too, C.W, Coenraad, M, Lo, R.H.G, Tan, B.S
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.10.2014
• Subjects: Aged; Angiography, Digital Subtraction - methods; Carcinoma, Hepatocellular - drug therapy; Catheters; Chemoembolization, Therapeutic - methods; Contrast Media; Feasibility Studies; Female; Hepatic Artery - diagnostic imaging; Humans; Image Enhancement - methods; Iohexol; Liver Neoplasms - drug therapy; Male; Microbubbles; Middle Aged; Phospholipids; Pilot Projects; Radiography, Interventional - instrumentation; Radiography, Interventional - methods; Radiology; Sulfur Hexafluoride; Tomography, X-Ray Computed - instrumentation; Tomography, X-Ray Computed - methods; Ultrasonography, Interventional - instrumentation; Ultrasonography, Interventional - methods
• ISSN: 0009-9260; 1365-229X
• DOI: 10.1016/j.crad.2014.06.001

Aim To investigate the feasibility and procedural value of catheter-directed contrast-enhanced ultrasound (CCEUS) compared with catheter-directed computed tomography arteriography (CCTA) in patients undergoing transarterial chemoembolization (TACE) guided by digital subtraction angiography (DSA). Materials and methods From December 2010 to December 2011, a pilot study was conducted including nine patients (mean age 66.6 years; SD 8.3 years; seven men) undergoing TACE with drug-eluting beads for unresectable hepatocellular carcinoma (HCC). Both CCEUS and CCTA were performed in addition to DSA. Alterations of treatment plan based on CCEUS were recorded and compared with CCTA. Results CCEUS provided additional information to DSA altering the treatment plan in four out of nine patients (44.4%). In these four patients, CCEUS helped to identify additional tumour feeders ( n  = 2) or led to a change in catheter position ( n  = 2). The information provided by CCEUS was similar to that provided by CCTA. Conclusion CCEUS is a potentially valuable imaging tool in adjunction to DSA when performing TACE and may provide similar information to CCTA.