Evaluation of liver parenchymal blood flow with contrast-enhanced US: preliminaryresults in healthy and cirrhotic patients

ùObjectives: We sought to investigate whether thalidomide is able to produce tumor vascular changes in patients with untreatable hepatocellular carcinoma (HCC) that can be detected using microbubble contrast agents. Materials and Methods: Eleven consecutive patients with untreatable HCC underwent contrast-enhanced ultrasound before and during thalidomide administration. Real-time destruction reperfusion kinetics was obtained from a representative HCC nodule and from the surrounding liver parenchyma during SonoVue infusion (Bracco, Milan, Italy) at a constant rate of 0.10 mL/s by using a syringe pump and modelized according to the mathematical function SI A(1 exp(t)) where the plateau signal intensity A reflects the percent blood volume, the time constant reflects the average speed of blood, and their product A* reflects the nutrient blood flow. Results: Size of the representative nodule reduced significantly 3 to 6 months after the start of thalidomide treatment. Before thalidomide administration A, , and A* of the index lesion were 44 60 LIU, 0.31 0.40 seconds1 and 8.1 11.8 LIU/s, respectively). A and A* reduced significantly after 15 days (26 50 LIU and 2.9 4.8 LIU/s, P 0.01), 3 months (12 18 LIU, and 4.3 7.7 LIU/s, P 0.01), and 6 months (13 23 LIU and 2.4 3.7 LIU/s, P 0.05) of treatment. No statistically significant changes of the exponential time constant were observed, nor changes of A, and A* in the liver parenchyma.