TY - JOUR
T1 - The role of contrast-enhanced ultrasound in guiding radiofrequency ablation of hepatocellular carcinoma
T2 - A retrospective study
AU - Chan, Andy K.W.
AU - Hegarty, Chris
AU - Klass, Darren
AU - Yoshida, Eric
AU - Chung, Stephen
AU - Liu, David M.
AU - Ho, Stephen G.F.
AU - Harris, Alison C.
N1 - Publisher Copyright:
© 2015 Canadian Association of Radiologists. All rights reserved.
PY - 2015/5/1
Y1 - 2015/5/1
N2 - Purpose The objective of the study was to determine the efficacy of contrast-enhanced ultrasound (CEUS) using ultrasound (US)-specific microbubbles in guiding radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC). Methods A retrospective analysis of 50 patients with HCC treated with CEUS guided RFA using perflutren at our institution was performed. CEUS images were first compared to B-mode US images performed at the same RFA session to determine the ability of CEUS to increase the conspicuity of lesions. A qualitative score (1 = poor, 2 = fair, 3 = excellent) was used to grade the ability to visualize the lesions. The preprocedure CEUS images were then evaluated using the most recent prior contrast enhanced computed tomography (CT) or magnetic resonance imaging (MRI). The efficacy of the treatment was evaluated with short-term follow-up imaging (median 1 month) for presence of residual or recurrent disease. Results CEUS allows at least fair visualization (score ≥2) in 78% (reader 1) and 80% (reader 2) of the lesions not visualized by B-mode US, and 50% (reader 1) and 42% (reader 2) of the lesions poorly visualized by B-mode US. Lesion appearances on CEUS are largely concordant with those on CT or MRI: 88% for reader 1, 96% for reader 2. With CEUS-guided RFA, complete response was achieved in the vast majority of the lesions at short-term follow-up: 82% for reader 1, 94% for reader 2. Conclusions CEUS increases the conspicuity and provides better characterization of hypervascular HCC that are either not seen or poorly seen on B-mode US, and CEUS provides real-time guidance of RFA with good short-term treatment responses.
AB - Purpose The objective of the study was to determine the efficacy of contrast-enhanced ultrasound (CEUS) using ultrasound (US)-specific microbubbles in guiding radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC). Methods A retrospective analysis of 50 patients with HCC treated with CEUS guided RFA using perflutren at our institution was performed. CEUS images were first compared to B-mode US images performed at the same RFA session to determine the ability of CEUS to increase the conspicuity of lesions. A qualitative score (1 = poor, 2 = fair, 3 = excellent) was used to grade the ability to visualize the lesions. The preprocedure CEUS images were then evaluated using the most recent prior contrast enhanced computed tomography (CT) or magnetic resonance imaging (MRI). The efficacy of the treatment was evaluated with short-term follow-up imaging (median 1 month) for presence of residual or recurrent disease. Results CEUS allows at least fair visualization (score ≥2) in 78% (reader 1) and 80% (reader 2) of the lesions not visualized by B-mode US, and 50% (reader 1) and 42% (reader 2) of the lesions poorly visualized by B-mode US. Lesion appearances on CEUS are largely concordant with those on CT or MRI: 88% for reader 1, 96% for reader 2. With CEUS-guided RFA, complete response was achieved in the vast majority of the lesions at short-term follow-up: 82% for reader 1, 94% for reader 2. Conclusions CEUS increases the conspicuity and provides better characterization of hypervascular HCC that are either not seen or poorly seen on B-mode US, and CEUS provides real-time guidance of RFA with good short-term treatment responses.
KW - Contrast enhanced ultrasound
KW - Gastrointestinal radiology
KW - Hepatocellular carcinoma
KW - Interventional radiology
KW - Radiofrequency ablation
KW - Ultrasound
UR - http://www.scopus.com/inward/record.url?scp=84928271192&partnerID=8YFLogxK
U2 - 10.1016/j.carj.2014.11.005
DO - 10.1016/j.carj.2014.11.005
M3 - Article
C2 - 25637354
AN - SCOPUS:84928271192
SN - 0846-5371
VL - 66
SP - 171
EP - 178
JO - Canadian Association of Radiologists Journal
JF - Canadian Association of Radiologists Journal
IS - 2
ER -