Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Oct 28, 2012; 18(40): 5753-5758
Published online Oct 28, 2012. doi: 10.3748/wjg.v18.i40.5753
Evaluation of sorafenib for hepatocellular carcinoma by contrast-enhanced ultrasonography: A pilot study
Kazue Shiozawa, Manabu Watanabe, Yoshinori Kikuchi, Takahide Kudo, Kenichi Maruyama, Yasukiyo Sumino
Kazue Shiozawa, Manabu Watanabe, Yoshinori Kikuchi, Yasukiyo Sumino, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital, Tokyo 143-8541, Japan
Takahide Kudo, Kenichi Maruyama, Department of Clinical Functional Physiology, Toho University Medical Center, Omori Hospital, Tokyo 143-8541, Japan
Author contributions: Shiozawa K, Watanabe M and Kikuchi Y designed the study; Kudo T and Maruyama K performed the examination; Shiozawa K and Watanabe M analyzed the data and wrote the manuscript; Sumino Y supervised the study.
Correspondence to: Manabu Watanabe, MD, PhD, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital, 6-11-1 Omorinishi, Ota-ku, Tokyo 143-8541, Japan. manabu62@med.toho-u.ac.jp
Telephone: +81-3-37624151 Fax: +81-3-37638542
Received: April 19, 2012
Revised: June 18, 2012
Accepted: July 18, 2012
Published online: October 28, 2012
Abstract

AIM: To determine the usefulness of arrival time parametric imaging (AtPI) using contrast-enhanced ultrasonography (CEUS) with Sonazoid in evaluating early response to sorafenib for hepatocellular carcinoma (HCC).

METHODS: Fourteen advanced HCC patients who received sorafenib 400/800 mg/d for at least 4 wk and were followed up by CEUS were enrolled in this study. CEUS was performed before treatment and 2 and 4 wk after treatment, and images of the target lesion in the arterial phase were recorded for each patient. The images were analyzed by AtPI. Color mapping (CM) images obtained by AtPI were compared before and after the treatment. In these CM images, the mean arrival time of the contrast agent in the region of interest from the starting point [mean time (MT)] was calculated. In each patient, differences between MT before and MT 2 and 4 wk after the treatment were compared with responses evaluated 4-8 wk after the treatment by dynamic computed tomography (CT), and statistical analysis was performed. Modified response evaluation criteria in solid tumors was used for the response evaluation.

RESULTS: In CM images both 2 and 4 wk after the treatment, delays in the arrival time of the contrast agent were noted in 8 of the 14 patients. In the other 6 patients, no color changes were observed in the tumor, or red and/or yellow increase, suggesting a decrease in blood flow velocity between images 2 and 4 wk after the treatment and those before the treatment. Dynamic CT could be performed 4-8 wk after the treatment in 13 of the 14 patients. Median differences in the MT were 1.13 s and 1.015 s, 2 and 4 wk after the treatment, respectively, in the 8 patients who showed stable disease (SD)/partial response (PR) on dynamic CT. Median differences in the MT were -0.39 s and -0.95 s, 2 and 4 wk after the treatment, respectively, in the 5 patients who showed progressive disease (PD). Differences in the median MT between SD/PR and PD groups were significant 2 and 4 wk after the treatment with P = 0.019 and P = 0.028, respectively.

CONCLUSION: AtPI by CEUS using Sonazoid is suggested to be useful for evaluating early responses to sorafenib.

Keywords: Sorafenib; Sonazoid; Contrast-enhanced ultrasonography; Hepatocellular carcinoma; Therapeutic response