| Purpose:To explore the value of quantitative analysis of contrast-enhanced ultrasound（CEUS） in early forecast and evaluation of the effect of chemotherapy and targetedtherapy onto colorectal carcinoma liver metastasis, and to provide experimentalevidence for early clinical development of treatment measures or determine the efficacyand prognosis.Methods:(1)Set inclusion criteria and exclusion criteria, and select the pre-chemotherapypatients between the ages of18-75years old confirmed by pathology/cytology, havemeasurable disease; no vital organs dysfunction, blood, liver, kidney function and heartfunction was normal, expected survival at3months or more, and can understand thisstudy and signed an informed consent form.(2)We performed normal ultrasonography and CEUS onto61CRC liver metastasispatients before the treatment and on days3,7,14,42, and60after the treatment.According to the results of chemotherapy, we divided the61patients with livermetastases of colorectal cancer into effective group and ineffective group.(3)Select the time intensity curve of six functional parameters, rise time(RT), meantransit time（mTT）, peak enhancement（PE）, wash-in area under curve（WiAUC）,wash-in rate（WiR）, wash-in perfusion index（WiPI）. Use SonoTumor QuantitativeAnalysis software to calculate the six functional parameters of time intensity curve.(4)We adopted the (mRECIST) to separately evaluate the efficacy of chemotherapyin colorectal cancer liver metastases for effective group and ineffective group, andanalysis the correlation between six functional parameters and mRECIST. Results:(1)chemotherapy effective group and chemotherapy ineffective group, thedifferences in the rise time (RT), mean transit time (mTT), wash-in area under the curve(WiAUC), peak enhancement (PE), wash-in rate (WiR) and wash-in perfusion index(WiPI) before the treatment for the effective group versus the ineffective group were notstatistically different significantly different have no statistical meanings (P>0.05).（2）CEUS quantitative analysis parameters of the effective bevacizumab groupshowed an variation in the rise time (RT) before the treatment extended(P<0.05), whilemean transit time (mTT), the wash-in area under curve (WiAUC), peak enhancement(PE), wash-in rate (WiR) and wash-in perfusion index (WiPI) changed (P>0.05) beforethe treatment. The ineffective bevacizumab group before the treatment versus the risetime (RT), mean transit time (mTT), wash-in area under the curve (WiAUC), peakenhancement (PE), wash-in rate (WiR) and wash-in perfusion index (WiPI) have nostatistical meanings (P>0.05).(3) Compared with the ineffective chemotherapy group, CEUS quantitativeanalysis parameters of the effective chemotherapy group showed an increase in the risetime (RT) extended (P<0.05) obviously on day3after the treatment, while the meantransit time (mTT), wash-in area under curve (WiAUC), peak enhancement (PE),wash-in rate (WiR) and wash-in perfusion index (WiPI) for the ineffectivechemotherapy group changed (P>0.05) on day3compared with the pre-treatmentresults.(4) Compared with the ineffective bevacizumab group, CEUS quantitative analysisparameters of the effective bevacizumab group showed an increase in the: rise time (RT)and, mean transit time (mTT) extended(P<0.05) obviously on day3after the treatment,while the wash-in area under curve (WiAUC), peak enhancement (PE), wash-in rate(WiR) and wash-in perfusion index (WiPI) for the ineffective bevacizumab groupdeclined (P>0.05) on day3compared with the pre-treatment results. Conclusion:(1)Six functional parameters(rise time (RT), mean transit time (mTT), wash-in areaunder the curve (WiAUC), peak enhancement (PE), wash-in rate (WiR) and wash-inperfusion index (WiPI)) of CEUS time intensity curve are key indicators to forecast andevaluate the effect of chemotherapy and targeted therapy onto colorectal carcinoma livermetastasis. Among them, rise time (RT) is an index for early forecast and evaluation ofthe effect of chemotherapy onto colorectal carcinoma liver metastasis. The rise time(RT)and mean transit time (mTT) are indexes for early forecast and evaluation of theeffect of targeted therapy onto colorectal carcinoma liver metastasis.(2)CEUS is expected to become the effect imaging methods in early forecast andevaluation of the effect of chemotherapy and targeted therapy onto colorectal carcinomaliver metastasis. |
