Display options
Share it on

Oncol Lett. 2016 Jan;11(1):208-212. doi: 10.3892/ol.2015.3874. Epub 2015 Nov 05.

Evaluation of contrast-enhanced ultrasonography for hepatocellular carcinoma prior to and following stereotactic body radiation therapy using the CyberKnife® system: A preliminary report.

Oncology letters

Kazue Shiozawa, Manabu Watanabe, Takashi Ikehara, Kojiro Kobayashi, Yuta Ochi, Yuta Suzuki, Kazuhiro Fuchinoue, Masataka Yoneda, Takeshi Kenmochi, Yusuke Okubo, Takayuki Mori, Hiroyuki Makino, Nobuhiro Tsukamoto, Yoshinori Igarashi, Yasukiyo Sumino

Affiliations

  1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Kanagawa 230-0012, Japan; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital, Tokyo 143-8541, Japan.
  2. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital, Tokyo 143-8541, Japan.
  3. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Kanagawa 230-0012, Japan.
  4. Department of Radiology, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Kanagawa 230-0012, Japan.

PMID: 26870190 PMCID: PMC4727166 DOI: 10.3892/ol.2015.3874

Abstract

The CyberKnife® is expected to be a novel local treatment for hepatocellular carcinoma (HCC), however, a long-term follow-up using dynamic computed tomography and magnetic resonance imaging is required to determine the effect of treatment in a number of the affected patients. Therefore, there is a requirement to evaluate procedures for early determination of the effect of CyberKnife treatment. The present study aimed to evaluate the changes in the hemodynamics of the tumors and the hepatic parenchyma surrounding the tumor prior to and following CyberKnife treatment for HCC. A total of 4 HCC patients were enrolled in this study. These patients underwent CyberKnife treatment and were evaluated by image analysis prior to and following treatment using contrast-enhanced ultrasonography (CEUS) with Sonazoid. CEUS was performed prior to treatment, at 2 and 4 weeks post-treatment, and every 4 weeks thereafter for as long as possible. The dynamics of the enhancement of the tumor and the hepatic parenchyma surrounding the tumor in the vascular phase, and the presence or absence of a hypoechoic area in the hepatic parenchyma surrounding the tumor in the post-vascular phase were assessed. Results showed that: i) In the patient with earlier changes, hemodynamic changes were evident in the tumor at 4 weeks and in the hepatic parenchyma surrounding the tumor at 2 weeks post-treatment, respectively; ii) the tumor showed hypoenhancement in all patients; and iii) with regard to findings in the hepatic parenchyma surrounding the tumor, strong hyperenhancement appeared in the vascular phase initially, followed by a hypoechoic area in the post-vascular phase. Evaluation of the hemodynamics of tumors and hepatic parenchyma surrounding the tumor using CEUS with Sonazoid may be therapeutically applicable, as it is less invasive than dynamic computed tomography (CT) and provides an early evaluation of the effectiveness of CyberKnife treatment.

Keywords: CyberKnife®; Sonazoid; contrast-enhanced ultrasonography; hepatocellular carcinoma; stereotactic body radiotherapy

References

  1. Eur Radiol. 2005 Apr;15(4):677-84 - PubMed
  2. N Engl J Med. 1991 Jan 3;324(1):1-8 - PubMed
  3. Radiology. 1991 Feb;178(2):493-7 - PubMed
  4. Oncology. 2008;75 Suppl 1:1-12 - PubMed
  5. Intervirology. 2009;52(4):213-22 - PubMed
  6. Clin Oncol (R Coll Radiol). 2010 Apr;22(3):157-72 - PubMed
  7. Med Phys. 2010 Jan;37(1):282-94 - PubMed
  8. Technol Cancer Res Treat. 2010 Oct;9(5):479-87 - PubMed
  9. Br J Radiol. 2010 Dec;83(996):1063-71 - PubMed
  10. Radiat Oncol. 2012 Oct 10;7:166 - PubMed
  11. World J Gastroenterol. 2012 Oct 28;18(40):5753-8 - PubMed
  12. PLoS One. 2013 Oct 11;8(10):e77472 - PubMed
  13. Onco Targets Ther. 2013 Oct 29;6:1527-32 - PubMed
  14. Radiat Oncol. 2014 May 28;9:120 - PubMed
  15. Onco Targets Ther. 2014 Jun 12;7:915-23 - PubMed
  16. J Med Ultrason (2001). 2010 Apr;37(2):81-6 - PubMed
  17. Am J Pathol. 1966 Apr;48(4):597-611 - PubMed
  18. Int J Radiat Oncol Biol Phys. 1995 Mar 30;31(5):1237-48 - PubMed
  19. Stereotact Funct Neurosurg. 1997;69(1-4 Pt 2):124-8 - PubMed

Publication Types