Efficacy of SH U 508 A (Levovist) in color Doppler ultrasonography of hepatocellular carcinoma vascularization.

To assess the efficacy of a new US contrast agent [SH U 508 A (Levovist), Schering] in evaluating hepatocellular carcinoma (HCC) vascularization, 38 patients with 43 lesions were submitted to color Doppler US before and after i.v. contrast medium administration. Four patients were studied after arterial chemoembolization. The patients had been selected on the basis of suboptimal color Doppler signals on baseline images. Each patient received two to four injections of Levovist in standard doses. Tumor vascularization was qualitatively graded on a 0-3 scale. Twelve tumors (27.9%) appeared avascular at baseline examinations, while 31 (72.1%) exhibited low to moderate flow signals. After contrast agent administration, color Doppler signals were markedly enhanced in 35/43 lesions (81.4%), lasting 40 to 240 seconds. The lack of enhancement was related to tumor hypovascularity (necrosis at CT), portal vein thrombosis, deep location and successful chemoembolization. The detection of flow signals in chemoembolized tumors was explained by the persistence of viable tumor tissue. After Levovist administration, flow signals were detectable in 97.6% of the HCCs. Therefore, Levovist proved to be an effective tool for color Doppler evaluation of HCC vascularization.