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World J Hepatol. Jul 18, 2015; 7(14): 1866-1874
Published online Jul 18, 2015. doi: 10.4254/wjh.v7.i14.1866
Usefulness of contrast enhanced ultrasound in monitoring therapeutic response after hepatocellular carcinoma treatment
Davide Roccarina, Matteo Garcovich, Maria Elena Ainora, Laura Riccardi, Maurizio Pompili, Antonio Gasbarrini, Maria Assunta Zocco
Davide Roccarina, Matteo Garcovich, Maria Elena Ainora, Laura Riccardi, Maurizio Pompili, Antonio Gasbarrini, Maria Assunta Zocco, Department of Internal Medicine, Catholic University of Sacred Heart, 00168 Rome, Italy
Author contributions: Roccarina D contributed to the revision of the literature and to the drawing up the review; Garcovich M contributed to the revision of the literature, to the revision of the English and to the figures; Ainora ME contributed to revision of the literature and to the bibliography; Riccardi L and Pompili M contributed to the revision of the review; Gasbarrini A contributed to final approval of the article to be published; Zocco MA contributed to the revision of the review, to the revision of the English and to the final approval of the article to be published.
Conflict-of-interest statement: Davide Roccarina has not received any source of support in the form of grants, equipment or drugs; Matteo Garcovich as not received any source of support in the form of grants, equipment or drugs; Maria Elena Ainora has not received any source of support in the form of grants, equipment or drugs; Laura Riccardi has not received any source of support in the form of grants, equipment or drugs; Maurizio Pompili has not received any source of support in the form of grants, equipment or drugs; Antonio Gasbarrini has not received any source of support in the form of grants, equipment or drugs; Maria Assunta Zocco has not received any source of support in the form of grants, equipment or drugs.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Davide Roccarina, Department of Internal Medicine, Catholic University of Sacred Heart, Largo A. Gemelli, 8, 00168 Rome, Italy. davideroccarina@gmail.com
Telephone: +39-06-30156018 Fax: +39-06-35502775
Received: December 2, 2014
Peer-review started: December 4, 2014
First decision: February 7, 2015
Revised: June 15, 2015
Accepted: July 11, 2015
Article in press: July 14, 2015
Published online: July 18, 2015
Processing time: 234 Days and 1.5 Hours
Abstract

In the last years, the development in the oncology field has been huge and rapid. In particular, the evaluation of response to anti-tumour treatments has been being object of intense research, producing significant changes. Response assessment after therapy in solid neoplasias has always used radiological imaging techniques, with tumour size reduction representing a presumed therapeutic efficacy. However, with the introduction of anti-angiogenetic drugs the evaluation of tumour size has become unsuitable because some tumours, under treatment, show only tumour perfusion changes rather than lesion shrinkage. Between different imaging techniques with contrast-enhancement, contrast-enhanced ultrasound (CEUS) and, in particular, dynamic CEUS have arisen as a promising and non-invasive device for monitoring cancer treatments. Moreover, the introduction of perfusion software has even more refined the technique since it is able to provide quantitative parameters related to blood flow and blood volume that can be associated with tumour response and clinical outcome such as the progression free survival and the overall survival. Here, we give an overview of the current status of CEUS in monitoring hepatocellular carcinoma response to different kind of treatments.

Keywords: Dynamic contrast-enhanced ultrasound; Hepatocellular carcinoma; Ablative treatment; Anti-angiogenetic drugs; Time-intensitive curve

Core tip: Hereby we present a literature revision about the current status of contrast enhanced ultrasound in monitoring hepatocellular carcinoma response to different kind of treatments. This is a very important topic because of the rapid development in the oncology field due to the introduction of novel anti-cancer therapies. Among different contrast enhanced imaging techniques, dynamic contrast-enhanced ultrasound has emerged as a versatile tool as standard radiological imaging has become unsatisfactory.