Contrast-enhanced ultrasonography for blood flow detection in hepatocellular carcinoma during lenvatinib therapy

Naoki Matsumoto, Masahiro Ogawa, Masahiro Kaneko, Shuhei Arima, Mariko Kumagawa, Yukinobu Watanabe, Midori Hirayama, Ryota Masuzaki, Tatsuo Kanda, Mitsuhiko Moriyama

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


Purpose: Blood flow reduction after initiation of lenvatinib therapy may not always indicate tumor necrosis. This study aimed to compare the blood flow detectability of contrast-enhanced ultrasonography (CEUS), contrast-enhanced computed tomography (CT), and contrast-enhanced magnetic resonance imaging (MRI) in hepatocellular carcinoma (HCC) during lenvatinib therapy. Methods: A total of 12 cases underwent CEUS and contrast-enhanced CT/MRI within 2 weeks during lenvatinib therapy. Vascularity on CEUS and CT/MRI was compared. Results: At the time of CEUS examination, the median period from the start of lenvatinib was 227 ± 210 (31–570) days. CEUS showed hyperenhancement in eight cases (66.7%), hypoenhancement in two cases (16.7%), and no enhancement in one case (8.3%), while CT/MRI showed hyperenhancement in one case (8.3%), ring enhancement in three cases (25.0%), and hypoenhancement in eight cases (66.7%) (p = 0.007). Transarterial chemoembolization (n = 3), radiofrequency ablation (n = 2), and stereotactic body radiation therapy (n = 2) were performed after blood flow detection by CEUS. Conclusions: The viability of the HCC should be confirmed using CEUS when contrast-enhanced CT/MRI reveals lesion hypoenhancement during lenvatinib therapy.

Original languageEnglish
Pages (from-to)425-432
Number of pages8
JournalJournal of Medical Ultrasonics
Issue number3
Publication statusPublished - Jul 2022


  • Computed tomography
  • Hepatocellular carcinoma
  • Lenvatinib mesylate
  • Magnetic resonance imaging
  • Ultrasonography


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