Echo-enhancing sonography of hepatic tumors

Background: A phase III clinical trial was conducted to evaluate the echoenhancing effects of a new ultrasound contrast medium, SH U 508 A, in hepatic tumors. Materials and Methods: Thirty-three patients with 57 hepatic nodules (1-5 cm in diameter; mean ± SEM, 2.4 ± 1.3 cm) were enrolled in this study. Twenty-four patients had hepatocellular carcinoma (HCC; 34 tumors) and nine patients had hepatic metastasis (23 tumors). Doses of 200, 300 or 400 mg/ml, respectively (6.5, 8.5 or 12.5 ml), of SH U 508 A were administered intravenously. The echo-enhancing effects were documented by using both a video recorder and a magneto-optical disk. An HDI 3000 system or a GP 8500 system with power Doppler ultrasound were applied to each nodule before and after contrast media injection. Results: The transit time for an enhancing effect was 10-18 seconds. Optimal viewing time was 50-220 seconds and washout time was 6-12 minutes. Echoenhancing effects were noted in 100% (34/34) of HCCs and 87% (20/23) of metastatic nodules, a total of 95% (54/57) positive enhancement. Different grading of enhancement was also observed between HCC and metastasis. Better enhancement was seen in HCC (82% ≥ Grade 2 vs 30% in metastasis; p < 0.001). Conclusion: Echo-enhanced liver ultrasound with SH U 508 A can improve power Doppler ultrasound images. Tumor vascularity can be better demonstrated. The use of SH U 508 A may contribute to treatment planning and improve confidence in diagnosis of hepatic tumors.