# 2D and 3D Contrast-enhanced Ultrasound Evaluation of Chemoembolization.

> **NIH NIH R01** · THOMAS JEFFERSON UNIVERSITY · 2024 · $641,575

## Abstract

Project Summary
Transarterial chemoembolization (TACE) is the recommended treatment option for patients with Barcelona Clinic
Liver Cancer Stage B hepatocellular carcinoma (HCC) but may also be used as a bridge therapy in HCC patients
who are potential transplant candidates. Additionally, this locoregional therapy is frequently used for the
treatment of other primary (cholangiocarcinoma) and metastatic liver cancers (colorectal cancer, breast cancer,
melanoma, neuroendocrine tumors, and some soft tissue sarcomas). Incomplete TACE treatment (observed in
up to two-thirds of patients) is defined as persistence of enhancing areas inside the treated lesions seen at the
first imaging follow up. Initial guidelines recommend follow-up contrast-enhanced MR or CT imaging 4-6 weeks
after all tumor-bearing areas have been treated. The inherent limitations of these modalities initially led our group
to pursue the use of contrast-enhanced ultrasound (CEUS) imaging as an alternative for assessing HCC
response to TACE earlier as part of this NIH grant R01 CA194307. Our prospective multi-center trial
demonstrated an improved sensitivity for detecting residual disease following TACE relative to clinical standard
of care CT/MR imaging (91.4% vs. 67.8%; p≤0.008) and an ability to identify patients requiring retreatment as
early as one-week post treatment. Importantly, data from this grant has in part lead to the recent decision by the
American College of Radiology to incorporate CEUS into its liver imaging reporting and data system (LI-RADS)
treatment response algorithm, supporting full clinical adoption.
In this funding cycle, we plan to build on this momentum to expand the role of CEUS within TACE while also
overcoming limitations in our prior study. First, we plan to evaluate the diagnostic performance of CEUS for
assessing TACE response in non-HCC tumors (which vary in vascularity and now makes up the majority of
cases at many institutions). Secondly, we plan to investigate the ability and diagnostic performance of TACE
intra-operatively. While treatment will not be altered as part of this proposal, once properly validated this could
enable immediate tumor retreatment and improve the overall response rates of TACE. Thirdly, we plan to
investigate a variety of advanced ultrasound techniques including improved volumetric CEUS, frequency
spectrum analysis, and off-line techniques for improving resolution of vascular structures. We hypothesize these
approaches will improve on the suboptimal specificity observed in our initial studies. Finally, we propose to
quantify tumor vascular morphology and blood flow dynamics prior to treatment as a means for predicting
treatment response (and ultimately personalizing the selection of locoregional therapy). Ultimately, this work will
continue to expand the role of CEUS in the setting of TACE by demonstrating applicability to a variety of solid
tumors, guiding treatment, and improving on the technique’s overall specificity.

## Key facts

- **NIH application ID:** 10879246
- **Project number:** 2R01CA194307-06A1
- **Recipient organization:** THOMAS JEFFERSON UNIVERSITY
- **Principal Investigator:** John Eisenbrey
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $641,575
- **Award type:** 2
- **Project period:** 2016-03-23 → 2029-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10879246

## Citation

> US National Institutes of Health, RePORTER application 10879246, 2D and 3D Contrast-enhanced Ultrasound Evaluation of Chemoembolization. (2R01CA194307-06A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10879246. Licensed CC0.

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