Hepatocellular carcinoma treated with transarterial chemoembolization: Evaluation with parametric contrast-enhanced ultrasonography

Figure 3 A case of hepatocellular carcinoma studied with non-parametric contrast-enhanced ultrasonography and parametric contrast-enhanced ultrasound before and after the first session of transarterial chemoembolization. A, B: Digital subtraction angiography of the tumor prior to (A) and post transarterial chemoembolization (TACE) (B), shows significant reduction in the angiographically detectable neovascularity after chemoembolization; C, D: Non-parametric contrast-enhanced ultrasonography (npCEUS) at the plane of longest tumor diameter prior to (C) and post TACE (D), shows post-therapeutic reduction in tumoral enhancement with non-enhanced, as well as hypoenhanced areas; E, F: Parametric images produced by analysis of tumor perfusion prior to (E) and post TACE (F), at the same plane as npCEUS. Lighter tones of gray represent areas with higher peak intensity (PI), while darker tones of gray represent hypoperfused areas, with lower PI; G, H: Time-intensity curves prior to (G) and post TACE (H) show an obvious reduction in PI and area under the curve during wash-in (AUC-WI) after TACE. SI: Signal intensity.