European Radiology Supplements

, Volume 17, Supplement 6, pp 89–98 | Cite as

Dynamic contrast-enhanced ultrasonography (DCE-US) with quantification of tumor perfusion: a new diagnostic tool to evaluate the early effects of antiangiogenic treatment

  • Nathalie Lassau
  • Linda Chami
  • Baya Benatsou
  • Pierre Peronneau
  • Alain Roche
Achieving Optimal Diagnostic Yield Using Real-Time CEUS


Dynamic contrast-enhanced ultrasonography (DCEUS) using the contrast agent Sonovue and vascular recognition imaging software is a novel technique that enables the detection of microvessels and quantitative assessment of solid tumor perfusion using raw linear data. Clinical trials have shown that DCE-US can be used to assess the anticancer efficacy of antiangiogenic treatment, for which conventional efficacy criteria based on size are unsuitable. Reduction in tumor vascularization can easily be detected in responders after 1–2 weeks and is correlated with progression-free survival and overall survival. DCE-US is supported by the French Cancer National Institut. This program is currently studying the technique in metastatic breast cancer, melanoma, colon cancer, gastrointestinal stromal tumor, and renal cell carcinoma, as well as in primary hepatocellular carcinoma, to establish the optimal perfusion parameters and timing for quantitative anticancer efficacy assessments.


Dynamic contrast-enhanced ultrasonography Tumor perfusion quantification Antiangiogenic treatments 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Rehman S, Jayson GC (2005) Molecular imaging of antiangiogenic agents. Oncologist 10:92–103PubMedCrossRefGoogle Scholar
  2. 2.
    Schwartz L (2004) Conventional and novel techniques for therapeutic response assessment. Radiological Society North America (RSNA). 90th Scientific Assembly and Annual Meeting, Chicago, December 2004Google Scholar
  3. 3.
    Benjamin RS, Choi H, Macapinlac HA et al (2007) We should desist using Recist, at least in GIST. J Clin Oncol 25:1760–1764PubMedCrossRefGoogle Scholar
  4. 4.
    Cosgrove D (2003) Angiogenesis imaging-ultrasound. Br J Radiol 76(Spec No 1):S43–S49PubMedCrossRefGoogle Scholar
  5. 5.
    Lassau N, Koscielny S, Opolon P et al (2001) Evaluation of contrast-enhanced color Doppler ultrasound for the quantification of angiogenesis in vivo. Invest Radiol 36:50–55PubMedCrossRefGoogle Scholar
  6. 6.
    Escudier B, Lassau N, Couanet D et al (2002) Phase II trial of thalidomide in renal-cell carcinoma. Ann Oncol 13:1029–1035PubMedCrossRefGoogle Scholar
  7. 7.
    Greis C (2004) Technology overview: SonoVue (Bracco, Milan). Eur Radiol 14[Suppl 8]:P11–P15PubMedGoogle Scholar
  8. 8.
    Lassau N, Lamuraglia M, Vanel D et al (2005) Doppler US with perfusion software and contrast medium injection in the early evaluation of isolated limb perfusion of limb sarcomas: prospective study of 49 cases. Ann Oncol 16:1054–1060PubMedCrossRefGoogle Scholar
  9. 9.
    Lassau N, Lamuraglia M, Chami L et al (2006) Gastrointestinal stromal tumors treated with imatinib: monitoring response with contrast-enhanced sonography. AJR Am J Roentgenol 187:1267–1273PubMedCrossRefGoogle Scholar
  10. 10.
    Lamuraglia M, Escudier B, Chami L et al (2006) To predict progression-free survival and overall survival in metastatic renal cancer treated with sorafenib: pilot study using dynamic contrast-enhanced Doppler ultrasound. Eur J Cancer 42:2472–2479PubMedCrossRefGoogle Scholar
  11. 11.
    Escudier B, Lassau N, Angevin E et al (2007) Phase I trial of sorafenib in combination with IFN alpha-2a in patients with unresectable and/or metastatic renal cell carcinoma or malignant melanoma. Clin Cancer Res 13:1801–1809PubMedCrossRefGoogle Scholar
  12. 12.
    Blay JY, Landi B, Bonvalot S et al (2005) Recommendations for the management of GIST patients. Bull Cancer 92:907–918PubMedGoogle Scholar
  13. 13.
    Choi H, Faria S, Benjamin R et al (2002) Monitoring treatment effects of STI-571 on gastrointestinal stromal tumors (GIST) with CT and PET: a quantitative analysis (abstract 583). RSNA Scientific program 2002, Chicago, ILGoogle Scholar
  14. 14.
    De Giorgi U, Aliberti C, Benea G, et al (2005) Effect of angiosonography to monitor response during imatinib treatment in patients with metastatic gastrointestinal stromal tumors. Clin Cancer Res 11:6171–6176PubMedCrossRefGoogle Scholar
  15. 15.
    Le Cesne A, Landi B, Bonvalot S et al (2005) Recommandations pour la prise en charge des tumeurs stromales gastro-intestinales. Hepato-Gastro 12:377–389Google Scholar
  16. 16.
    Lamuraglia M, Le Cesne A, Chami L et al (2006) Dynamic contrast-enhanced Doppler ultrasound (DCEUS) is a useful radiological assessment to early predict the outcome of patients with gastrointestinal stromal tumors (GIST) treated with imatinib (IM). J Clin Oncol (2006 ASCO Annual Meeting Proceedings, Post Meeting Edition, June 20) 24:529SGoogle Scholar
  17. 17.
    Le Cesne A, Landi B, Bonvalot S et al (2006) Recommendations for the management of gastro-intestinal stromal tumors. Ann Pathol 26:231–234PubMedCrossRefGoogle Scholar
  18. 18.
    Kaelin WG (2002) Molecular basis of the VHL hereditary cancer syndrome. Nat Rev Cancer 2:673–682PubMedCrossRefGoogle Scholar
  19. 19.
    Therasse P, Arbuck SG, Eisenhauer EA et al (2000) New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 92:205–216PubMedCrossRefGoogle Scholar
  20. 20.
    McCarville MB, Streck CJ, Dickson PV et al (2006) Angiogenesis inhibitors in a murine neuroblastoma model: quantitative assessment of intratumoral blood flow with contrast-enhanced gray-scale US. Radiology 240:73–81PubMedCrossRefGoogle Scholar
  21. 21.
    Kruskal JB (2006) Science to practice: will improved assessment of response to antiangiogenic therapies be achieved with contrast-enhanced grayscale US? Radiology 240:1–2PubMedCrossRefGoogle Scholar
  22. 22.
    Soria JC, Lazar V, Lassau N et al (2007) Sorafenib (S) and dacarbazine (D) combination in patients with advanced malignant solid tumors: phase I study with tumor biopsy genomic analysis and dynamic contrast enhanced ultrasonography (DCE-US). 2007 ASCO Annual Meeting Proceedings. J Clin Oncol 25[Suppl 18]:151sGoogle Scholar
  23. 23.
    Lassau N, Chami L, Peronneau P (2007) Imaging of melanoma: accuracy of ultrasonography before and after contrast injection for diagnostic and early evaluation of treatment. Bull Cancer 94:93–98PubMedGoogle Scholar

Copyright information

© European Society of Radiology 2007

Authors and Affiliations

  • Nathalie Lassau
    • 1
  • Linda Chami
    • 1
  • Baya Benatsou
    • 1
  • Pierre Peronneau
    • 1
  • Alain Roche
    • 1
  1. 1.Imaging Department and Imaging Laboratory of Small AnimalsUPRES EA 40-40 Institut Gustave-RoussyVillejuifFrance

Personalised recommendations