Contrast-enhanced ultrasound for evaluating response to pulsed-wave high-intensity focused ultrasound therapy in advanced pancreatic cancer

Author(s):  
Yu Yang ◽  
Xian-quan Shi ◽  
Guang Chen ◽  
Xiao-na Zhou ◽  
Lin-xue Qian

OBJECTIVE: To examine whether contrast-enhanced ultrasound (CEUS) parameters in patients with advanced pancreatic cancer could be used to assess response to treatment with pulsed-wave high intensity focused ultrasound (PW-HIFU). METHODS: We prospectively recorded the pretreatment and posttreatment CEUS related parameters, CA19-9, pain scores of 30 patients with advanced pancreatic cancer treated with PW-HIFU treatment. Correlation of clinical parameters, tumor characteristics, and PW-HIFU treatment energy with CEUS parameters were analyzed. RESULTS: Pain score decreased after treatment (from 4.80±2.14 to 3.28±1.93, p = 0.001). CA19-9 dropped in RT decreased group, 4 weeks after one session PW-HIFU, compared with prolonged group (p = 0.013). According to the display of blood vessels in the mass by CEUS, tumors were classified by vessel grade (VG), VG1: no vessel can be seen; VG 2: vessels diameter <  5 mm; VG 3: vessels diameter >  5 mm. VGs were different between increased and decreased relative rise intensity (rRI) groups (p = 0.008). VG1 group shown a decreased rRI after treatment, while VG3 group showed the opposite trend (p = 0.006). CONCLUSIONS: CEUS can evaluating response to PW-HIFU in advanced pancreatic cancer. Quantitative analysis may help to assess the short-term efficacy of patients and help for individualized treatment.

Author(s):  
Zuo Dan ◽  
Feng Yi ◽  
Zhang Qi ◽  
Qiu Yi-Jie ◽  
Tian Xiao-Fan ◽  
...  

PURPOSE: To evaluate the feasibility of dynamic contrast enhanced ultrasound (DCE-US) in predicting treatment response of high-intensity focused ultrasound (HIFU) in patients with locally advanced pancreatic cancer (LAPC) lesions. PATIENTS AND METHODS: In this prospective study, 10 patients with pathologically confirmed LAPC lesions (7 men, 3 women; average age, 61.13±5.80 years) were prospectively enrolled. All patients received HIFU treatment with peak intensity at 12000 W/cm2. Contrast enhanced ultrasound (CEUS) was performed with an ACUSON Oxana 2 ultrasound equipment and a 6 C-1 transducer (1–6 Hz). A dose of 2.4 ml SonoVue was injected for each examination. Time intensity curves (TICs) were generated and quantitative analyses were performed by SonoLiver software. B mode ultrasound (BMUS) features, CEUS enhancement patterns, TICs, CEUS quantitative parameters and serum carcinoma antigen 19-9 (CA19-9) levels were compared before and 4 weeks after HIFU treatment. Statistical analyses were performed with SPSS Version 20.0 and GraphPad Prism 5. RESULTS: While comparing before and after HIFU, no significant difference was obtained on mean size of lesion, BMUS or CEUS features. After HIFU treatment, TICs showed decreased and delayed enhancement. Among all CEUS quantitative parameters, significant decrease could be found in maximum intensity (MI) (60.66±23.95% vs 41.31±26.74%) and mean transit time (mTT) (76.66±47.61 s vs 38.42±28.35 s). CA19-9 level decreased significantly after HIFU (2747.92±4237.41 U/ml vs 715.08±1773.90 U/ml) (P = 0.05). CONCLUSION: DCE-US combining with quantitative analysis might be a useful imaging method for early treatment response evaluation of HIFU in LAPC lesions.


2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Yufeng Zhou

Pancreatic cancer is under high mortality but has few effective treatment modalities. High-intensity focused ultrasound (HIFU) is becoming an emerging approach of noninvasively ablating solid tumor in clinics. A variety of solid tumors have been tried on thousands of patients in the last fifteen years with great success. The principle, mechanism, and clinical outcome of HIFU were introduced first. All 3022 clinical cases of HIFU treatment for the advanced pancreatic cancer alone or in combination with chemotherapy or radiotherapy in 241 published papers were reviewed and summarized for its efficacy, pain relief, clinical benefit rate, survival, Karnofsky performance scale (KPS) score, changes in tumor size, occurrence of echogenicity, serum level, diagnostic assessment of outcome, and associated complications. Immune response induced by HIFU ablation may become an effective way of cancer treatment. Comments for a better outcome and current challenges of HIFU technology are also covered.


2017 ◽  
Vol 197 (4S) ◽  
Author(s):  
Andre Luis Abreu ◽  
Daniel Freitas ◽  
Daniel Park ◽  
Toshitaka Shin ◽  
Masakatsu Oishi ◽  
...  

2019 ◽  
Vol 61 (8) ◽  
pp. 1125-1133
Author(s):  
Chenxia Li ◽  
Chao Jin ◽  
Ting Liang ◽  
Xiang Li ◽  
Rong Wang ◽  
...  

Background In magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) treatment of uterine fibroids, the immediate ablation response is significantly affected by blood perfusion. The variability of measurement for blood perfusion is critical due to the inherent non-uniformity of tumor perfusion and its dependence on reproducible region of interest (ROI) placement. Purpose To investigate the value of whole-tumor ROI (ROIwt) analysis for quantitative perfusion in predicting immediate ablation response of uterine fibroids in MR-HIFU. Material and Methods Thirty-one fibroids in 28 eligible patients were treated with MR-HIFU. Quantitative perfusion parameters (Ktrans, Kep, and Vp) derived from dynamic contrast-enhanced MRI were obtained before MR-HIFU treatment. The ROIwt and single-layer ROI (ROIsl) were used for quantitative perfusion analysis. T1 contrast-enhanced MRI immediately after MR-HIFU treatment was conducted to determine the non-perfused volume ratio (NPVR). Intraclass correlation coefficient (ICC) was used for consistency test. Spearman’s correlation and multivariate linear regression were used to investigate the predictors of the NPVR. Received operating characteristic (ROC) curve was used to test the predictive efficacy of quantitative perfusion parameter. Results The intra- and inter-observer ICC of the quantitative perfusion parameters from ROIwt were higher than those from ROIsl. Multivariate analysis showed that the Ktrans of ROIwt was a predictor of the immediate ablation response. ROC analysis displayed that the AUC of Ktrans of ROIwt is 0.817 in predicting the ablation response. Conclusion Pretreatment Ktrans of ROIwt is more reliable and stable than that of ROIsl. It could be a predictor for the immediate ablation response of uterine fibroids in MR-HIFU.


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