High intensity focused ultrasound for the treatment of portal vein tumor thrombus of hepatocellular carcinoma

Objective To evaluate the efficacy, safety and clinical value of high intensity focused ultrasound (HIFU) for the treatment of portal vein tumor thrombus (PVTT) in patients with liver cancer. Methods A total of 26 patients with advanced liver carcinoma (including 33 PVTT portal veins and their main branches) were treated with HIFU. The changes in the blood flow of PVTT embolized portal veins, echo and size of tumor thrombi, liver function, ascites and the life quality were observed. Results Before treatment there was no blood flow signal with low echo and equivalent echo on color Doppler ultrasonography in 8 PVTT embolized portal veins. After 2 or 3 treatments, the low or equivalent echo became moderate or strong echo; the volumes of tumor thrombi were reduced by 1/3 to 1/2; and color flow signals were seen in 7 portal veins. After 3 or 5 treatments, the echo of tumor thrombi was significantly enhanced; and the volumes of tumor thrombi were reduced 1/5 to 1/2; and the flow signals became continuous and stable, indicating re-patency. The improvements of liver function, ascites and the life quality in varying degrees were observed. Conclusions HIFU treatment may be an effective, safe, less painful and non-invasive procedure in the control of PVTT in liver cancer patients.