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Detection of tumor vascularity in hepatocellular carcinoma with contrast-enhanced Dynamic Flow imaging: Comparison with contrast-enhanced power Doppler imaging

Journal of Medical Ultrasonics volume 30, pages 141–151 (2003)Cite this article

Abstract

Objective: To compare the effectiveness of contrast-enhanced Dynamic Flow imaging and contrast-enhanced power Doppler imaging using Levovist® as a microbubble contrast agent in evaluating intratumoral vascularity in hepatocellular carcinoma (HCC).Materials and Methods: Twenty-nine patients with 54 hepatocellular carcinoma nodules (before treatment, 31; after treatment, 23) were studied with both Dynamic Flow and power Doppler imaging with intravenous injection of Levovist®. Tumor vascularity was categorized as 0, no blood flow signals within the tumor; 1, dotlike blood flow signals within the tumor; 2, moderate blood flow signals within the tumor; and 3, abundant blood flow signals within the tumor. Detectability of intratumoral vascularity of hepatocellular carcinoma in three groups based on tumor depth, blooming and noise artifacts on contrast-enhanced Dynamic Flow and contrast-enhanced power Doppler imaging were also compared with results obtained using dynamic CT as a the gold standard. The effectiveness of contrast-enhanced Dynamic Flow and contrast-enhanced power Doppler imaging in assessing therapeutic effect were compared at the same time.Results: The ability of contrast-enhanced Dynamic Flow Doppler imaging to detect tumor vascularity in the superficial and intermediate hepatocellular carcinoma groups was close to that of contrast-enhanced power Doppler imaging (p>0.05). However, contrast-enhanced Dynamic Flow imaging demonstrated tumor parenchymal stain in 28 hepatocellular carcinoma nodules (61%), which was not detected by contrast-enhanced power Doppler imaging. Further, significantly fewer artifacts appeared in contrast-enhanced Dynamic Flow imaging than in contrast-enhanced power Doppler imaging (p<0.001). In assessing therapeutic response, the sensitivity of contrast-enhanced Dynamic Flow imaging was similar to that of dynamic CT. In deep areas, however, those more than 6 cm below the surface of the body, contrast-enhanced Dynamic Flow imaging was less sensitivity than contrast-enhanced power Doppler imaging (p=0.005).Conclusion: Contrast-enhanced Dynamic Flow imaging provides an effective approach to assessing intratumoral vascularity and therapeutic response in HCC lesions situated less than 6 cm from the surface of the body. It is superior to contrast-enhanced power Doppler imaging in its ability to detect tumor parenchymal stain and production of fewer artifacts.

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Affiliations

  1. Department of Gastroenterology and Hepatology, Kinki University School of Medicine, 377-2, 589-8511, Ohno-higashi, Japan

    Yan Ling Wen, Masatoshi Kudo SJSUM, Yasunori Minami, Hobyung Chung, Yoichiro Suetomi, Hirokazu Onda, Masayuki Kitano & Toshihiko Kawasaki SJSUM

  2. Abdominal Ultrasound Unit, Kinki University School of Medicine, 377-2, 589-8511, Ohno-higashi, Japan

    Kiyoshi Maekawa

  3. Department of Ultrasound, Sun Yut-Sen University of Medical Science Memorial Hospital, 107 Yanjiangxi Road, 510120, Guangzhou, China

    Yan Ling Wen

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  1. Yan Ling Wen
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  2. Masatoshi Kudo SJSUM
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  3. Yasunori Minami
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  4. Hobyung Chung
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  5. Yoichiro Suetomi
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  6. Hirokazu Onda
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  7. Masayuki Kitano
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  8. Toshihiko Kawasaki SJSUM
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  9. Kiyoshi Maekawa
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Wen, Y.L., Kudo, M., Minami, Y. et al. Detection of tumor vascularity in hepatocellular carcinoma with contrast-enhanced Dynamic Flow imaging: Comparison with contrast-enhanced power Doppler imaging. J Med Ultrasonics 30, 141–151 (2003). https://doi.org/10.1007/BF02481219

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  • DOI: https://doi.org/10.1007/BF02481219

Keywords

  • contrast medium
  • liver neoplasm
  • hepatocellular carcinoma
  • power Doppler imaging
  • wide-band Doppler imaging