Development of the prediction system of the early response of theSorafenib for advanced hepatocellular carcinoma using contrast enhanced ultrasonography

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There is no established way to predict the early response of the Sorafenib for advanced hepatocellular carcinoma. It is reported that tumor blood flow of effective cases decreased soon after the start of Sorafenib. Contrast enhanced ultrasonography （CEUS）is expected for the predictor, because it provides a high spatial and time resolution. Time intensity curve (TIC) analyses were performed using CEUS before and 2 weeks after administration of Sorafenib. Five parameters based on TIC analysis (peak intensity, PI; time to peak intensity, TTP; area under the curve, AUC; rise time, RT; wash in slope, WIS) were calculated. RT was defined as the time taken to transition from5 to 95% of PI. We compared the changes of these parameters (Change Rate: post 2 weeks value / pre administration value) with clinical parameters, and indicated the rise time was the most important factor. If the change rate of RT was more than 1.23, we could detect effective cases (100% sensitivity and 83% specificty of the effectiveness of the SD more),and also indicated the good correlation with overall survival time (r = 0.882).