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Contrast-enhanced ultrasonography for blood flow detection in hepatocellular carcinoma during lenvatinib therapy

  • Original Article–Gastroenterology
  • Published:
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Abstract

Purpose

Blood flow reduction after initiation of lenvatinib therapy may not always indicate tumor necrosis. This study aimed to compare the blood flow detectability of contrast-enhanced ultrasonography (CEUS), contrast-enhanced computed tomography (CT), and contrast-enhanced magnetic resonance imaging (MRI) in hepatocellular carcinoma (HCC) during lenvatinib therapy.

Methods

A total of 12 cases underwent CEUS and contrast-enhanced CT/MRI within 2 weeks during lenvatinib therapy. Vascularity on CEUS and CT/MRI was compared.

Results

At the time of CEUS examination, the median period from the start of lenvatinib was 227 ± 210 (31–570) days. CEUS showed hyperenhancement in eight cases (66.7%), hypoenhancement in two cases (16.7%), and no enhancement in one case (8.3%), while CT/MRI showed hyperenhancement in one case (8.3%), ring enhancement in three cases (25.0%), and hypoenhancement in eight cases (66.7%) (p = 0.007). Transarterial chemoembolization (n = 3), radiofrequency ablation (n = 2), and stereotactic body radiation therapy (n = 2) were performed after blood flow detection by CEUS.

Conclusions

The viability of the HCC should be confirmed using CEUS when contrast-enhanced CT/MRI reveals lesion hypoenhancement during lenvatinib therapy.

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Acknowledgements

The authors thank Editage (https://www.editage.jp/) for the English language review.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan

    Naoki Matsumoto, Masahiro Ogawa, Masahiro Kaneko, Shuhei Arima, Mariko Kumagawa, Yukinobu Watanabe, Midori Hirayama, Ryota Masuzaki, Tatsuo Kanda & Mitsuhiko Moriyama

Authors
  1. Naoki Matsumoto
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  2. Masahiro Ogawa
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  3. Masahiro Kaneko
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  4. Shuhei Arima
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  5. Mariko Kumagawa
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  6. Yukinobu Watanabe
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  7. Midori Hirayama
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  8. Ryota Masuzaki
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  9. Tatsuo Kanda
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  10. Mitsuhiko Moriyama
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Correspondence to Naoki Matsumoto.

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The authors declare that there are no conflicts of interest.

Ethical approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions.

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Owing to the retrospective nature of this study, informed consent was waived.

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Matsumoto, N., Ogawa, M., Kaneko, M. et al. Contrast-enhanced ultrasonography for blood flow detection in hepatocellular carcinoma during lenvatinib therapy. J Med Ultrasonics 49, 425–432 (2022). https://doi.org/10.1007/s10396-022-01204-8

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  • DOI: https://doi.org/10.1007/s10396-022-01204-8

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