Évaluation de la réponse thérapeutique en échographie de contraste

The development of special ultrasound contrast products since the early 2000s has rapidly improved performance and expanded the use of ultrasound in clinical practice and research. In parallel with the development of functional imaging, the use of contrast ultrasound was developed in the evaluation of tumoral response to treatment. Methods of quantification have been developed allowing, after bolus injection of a contrast agent, to calculate parameters correlated with the flow and the vascular volume. A multicentric study conducted between 2007 and 2010 found that a 40% decrease in the area under the curve, at one month from the start of treatment, is correlated with the vascular volume and, was the best predictor of good response to treatment in terms of progression-free survival and overall survival. The recommendations of the EFSUMB published in 2004 and updated in 2008 and 2012 highlight the recommendations, indications, contraindications and especially the technical requirements of the use of contrast ultrasound. The 2012 guidelines propose as a new indication the evaluation of the therapeutic response with a level of validation A1b according to the Oxford criteria of Evidence-Based Medicine. The latest recommendations of 2017 are in the process of being published.