Feasibility 3D Perfusion Ultrasound for Liver Cancer SABR Planning and Response Evaluation

Primary Objective:

The primary objectives of this prospective pilot study is to:

• determine the feasibility and reproducibility of 3D contrast enhanced ultrasound imaging in liver cancer patients undergoing Stereotactic Ablative Radiotherapy and
• evaluate whether there are treatment induced early changes in imaging metrics derived from 3D contrast enhanced ultrasound. This study will provide valuable insight as to the potential of baseline and/or early post-treatment 3D ultrasound perfusion characteristics (measurements of blood-flow) of primary and metastatic liver tumors to predict tumor response to Stereotactic Ablative Radiotherapy. The investigators' underlying goal is to assess whether early perfusion changes at 1-7 days after SABR initiation can be used as a non-invasive early biomarker for treatment response assessment.

Secondary Objectives:

Evaluate the feasibility of contrast-enhanced ultrasound-to-CT fusion by assisting three-dimensional (3D) perfusion ultrasound (US) imaging with optical and electromagnetic tracking of the ultrasound probe on patients with liver cancer that will undergo CT for treatment planning and/or response evaluation.

Inclusion criteria

• Ability to understand and willingness to sign the written informed consent document
• Patient with primary liver tumor or metastasis scheduled for Stereotactic Ablative Radiotherapy (SABR)
• Patient is at least 18 years of age. No gender/race-ethnic restrictions.
• Performance status (ECOG) between 0-3
• History and Physical done within 4 weeks of enrollment.

Exclusion criteria

• Patient has previously been enrolled in and completed this study.
• Known right to left cardiac shunt, bidirectional or transient.
• Patient has any medical condition or other circumstances which would significantly decrease the chances of obtaining reliable data, achieving study objectives, or completing the study and/or post-dose follow-up examinations.
• History of hypersensitivity to the contrast agent perflutren
• History of pulmonary hypertension
• Patients who are pregnant or are trying to become pregnant