Skip to main content
SpringerLink
Log in

Hemodynamic changes during balloon-occluded transarterial chemoembolization (B-TACE) of hepatocellular carcinoma observed by contrast-enhanced ultrasound

  • Case Report
  • Published:
Journal of Medical Ultrasonics Aims and scope Submit manuscript

Abstract

Balloon-occluded transarterial chemoembolization (B-TACE) is able to achieve denser accumulation of Lipiodol emulsion (LE) in hepatocellular carcinoma (HCC) than conventional TACE. However, to maximize the therapeutic effect of B-TACE, it is imperative to understand the hemodynamic changes that occur during arterial occlusion. We here present two patients with HCC in whom the hemodynamic changes during arterial occlusion were depicted and evaluated by contrast-enhanced ultrasound (CEUS). Arterial flow beyond the catheter tip was observed by CEUS even after balloon occlusion. In one patient, a reduction in arterial blood flow in the HCC was observed by CEUS during balloon occlusion of the target area for embolization. After B-TACE, dense LE accumulation in the HCC nodule was confirmed by flat-panel detector CT, indicating an excellent therapeutic effect. In the other patient, no changes in arterial blood flow in the HCC nodule were observed by CEUS during balloon occlusion of the target area for embolization. After B-TACE, intermediate LE accumulation in the HCC nodule was confirmed by flat-panel detector CT, indicating an incomplete therapeutic effect. The findings obtained in the two patients presented here suggest that B-TACE can be performed more effectively and reliably by monitoring blood flow using CEUS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Irie T, Kuramochi M, Takahashi N. Dense accumulation of Lipiodol emulsion in hepatocellular carcinoma nodule during selective balloon-occluded transarterial chemoembolization: measurement of balloon-occluded arterial stump pressure. Cardiovasc Interv Radiol. 2013;36:706–13.

    Article  Google Scholar 

  2. Cho KJ, Lunderquist A. The peribiliary vascular plexus: the microvascular architecture of the bile duct in the rabbit and in clinical cases. Radiology. 1983;147:357–64.

    CAS  PubMed  Google Scholar 

  3. Demachi H, Matsui O, Takashima T. Scanning electron microscopy of intrahepatic microvasculature casts following experimental hepatic artery embolization. Cardiovasc Interv Radiol. 1991;14:158–62.

    Article  CAS  Google Scholar 

  4. Tohma T, Cho A, Okazumi S, et al. Communicating arcade between the right and left hepatic arteries: evaluation with CT and angiography during temporary balloon occlusion of the right or left hepatic artery. Radiology. 2005;237:361–5.

    Article  PubMed  Google Scholar 

  5. Ekataksin W. The isolated artery: an intrahepatic arterial pathway that can bypass the lobular parenchyma in mammalian livers. Hepatology. 2000;31:269–79.

    Article  CAS  PubMed  Google Scholar 

  6. Kita R, Sakamoto A, Nagata Y, Nishijima N, Ikeda A, Matsuo H, et al. Visualization of blood drainage area from hypervascular hepatocellular carcinoma on ultrasonographic images during hepatic arteriogram: comparison with depiction of drainage area on contrast-enhanced ultrasound. Hepatol Res. 2012;42:999–1007.

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that there are no conflicts of interest.

Ethical standard

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 1975, as revised in 2008 [5]. Informed consent was obtained from all patients for inclusion in the study.

Author information

Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan

    Katsutoshi Sugimoto, Yasuharu Imai & Fuminori Moriyasu

  2. Department of Radiology, Tokyo Medical University, Tokyo, Japan

    Toru Saguchi & Kazuhiro Saito

Authors
  1. Katsutoshi Sugimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Toru Saguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kazuhiro Saito
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yasuharu Imai
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Fuminori Moriyasu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Katsutoshi Sugimoto.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (MPG 4998 kb)

About this article

Cite this article

Sugimoto, K., Saguchi, T., Saito, K. et al. Hemodynamic changes during balloon-occluded transarterial chemoembolization (B-TACE) of hepatocellular carcinoma observed by contrast-enhanced ultrasound. J Med Ultrasonics 41, 209–215 (2014). https://doi.org/10.1007/s10396-013-0487-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10396-013-0487-7

Keywords

Search

Navigation