Objective: To evaluate the value of Sonazoid in chemotherapeutic therapy for metastatic liver cancer (MLC). Methods: There were 30 patients with MLC who were clinically confirmed and planned to receive chemotherapy. All patients underwent contrast-enhanced computer tomography (CECT) or contrast-enhanced magnetic resonance imaging (CEMRI) and contrast-enhanced ultrasound (CEUS) examinations before chemotherapy and after 2 courses of chemotherapy. For multiple lesions

the largest lesions were selected for CEUS observation. The quantitative parameters of CEUS time intensity curve (TIC) of lesions and normal liver tissue before chemotherapy were compared and analyzed

includingcontrast agent arrive time(AT)

basic intensity before contrast agent arrival (BI)

ascending slope of contrast agent (AS)

peak time to peak (TTP)

peak intensity (PI) and area under 3-minute curve (AUC). After two cycles of chemotherapy

CECT or CEMRI evaluated the efficacy according to mRECIST criteria

and 30 patients were divided into effective group and ineffective group. Quantitative parameters of TIC curve of each lesion before and after chemotherapy were compared and analyzed between the two groups. Result: (1) CECT or CEMRI efficacy evaluation results showed that there were 10 cases in the effective group and 20 cases in the ineffective group. CEUS and CECT or CEMRI showed a high degree of synchronicity in the maximum diameter change of MLC lesion enhancement area

up to 96.7%. (2) Before chemotherapy

TTP

PI and AUC values of 30 metastases in 30 MLC patients were lower than those in normal liver tissue

with statistically significant differences (P<0.05)

while BI

AT and AS showed no statistically significant differences with surrounding liver tissue (P>0.05). Necrosis occurred in 12 lesions

and the TIC curve of necrotic lesions presented a straight line. (3) There was no significant difference in parameters before chemotherapy between the ineffective group and the effective group (P>0.05). There was no statistical significance in parameters of ineffective group before and after chemotherapy (P>0.05). BI

PI and AUC values of effective group decreased after chemotherapy compared with those before chemotherapy

with statistical significance (P<0.05)

while AT

TTP and AS showed no statistical significance before and after chemotherapy (P>0.05). (4) The difference of BI before and after chemotherapy (△BI)

PI before and after chemotherapy (△PI) and AUC before and after chemotherapy (△AUC) between the effective group and the ineffective group was statistically significant (P<0.05). △BI

△PI and △AUC values were 0.795

0.785 and 0.920

respectively. The optimal cut-off values were 0.075dB

2.24dB and 432.18dB×s

respectively. The corresponding Youden indices were 0.550

0.600 and 0.800. The sensitivity was 90%

100%

100%

and the specificity was 65%

60%

80%. Conclusion: CEUS can effectively identify the metastases

normal liver tissue and necrotic areas. CEUS can quantitatively evaluate the changes of vascular distribution during chemotherapy

and the quantitative parameters BI

PI and AUC are of great significance in the evaluation of chemotherapy efficacy in MLC patients.