Evaluation of therapeutic response to gemcitabine in pancreatic cancer.

BACKGROUND/AIMS: Due to the development of contrast-enhanced harmonic imaging, ultrasound can reveal more precise hemodynamic information than conventional angiography. In this study, the value of contrast-enhanced harmonic imaging was studied in the evaluation of response in treatment of pancreatic cancer. METHODOLOGY: Thirteen pancreatic cancer patients treated with gemcitabine were enrolled in this study. Contrast-enhanced harmonic ultrasonography was performed to evaluate the treatment response during every period of treatment. After intravenously injecting the contrast agent, pancreatic tumors were observed in a real-time and subsequently in an intermittent fashion. Findings obtained by contrast-enhanced harmonic imaging were compared with dynamic CT findings and serum tumor marker levels. RESULTS: Tumor markers were reduced by at least 50% in 6 patients. We could not evaluate tumor size reduction rates on the B-mode US because the tumor margin was unclear. On the other hand, the hypovascular area was clearly depicted on the perfusion image of contrast-enhanced harmonic imaging in all patients throughout the observation period, and changes in tumor size could be easily evaluated. The tumor size reduction rates in these 6 cases were 13.1 +/- 5.5% by dynamic CT and 21.1 +/- 14.1% by contrast-enhanced harmonic imaging. CONCLUSIONS: Contrast-enhanced harmonic imaging is useful for evaluating treatment response for pancreatic cancer.