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Abdom Radiol (NY). 2016 Aug;41(8):1511-21. doi: 10.1007/s00261-016-0700-4.

Role of contrast-enhanced ultrasound (CEUS) in evaluation of thermal ablation zone.

Author information

1
Department of Radiology, Keck School of Medicine, University of Southern California, 1500 San Pablo Street, Second Floor Imaging, Los Angeles, CA, 90033, USA.
2
Department of Radiology, Keck School of Medicine, University of Southern California, 1500 San Pablo Street, Second Floor Imaging, Los Angeles, CA, 90033, USA. mnayyar@usc.edu.
3
Department of Radiology, Keck School of Medicine, University of Southern California, 2001 North Soto Street, Soto Building 210B, Los Angeles, 90089, USA.

Abstract

PURPOSE:

Thermal ablation has emerged as a mainstay therapy for primary and metastatic liver malignancy. Percutaneous thermal ablation is usually performed under CT and/or ultrasound guidance. CT guidance frequently utilizes iodinated contrast for tumor targeting, with additional radiation and contrast required at the end of the procedure to ensure satisfactory ablation margins. Contrast-enhanced ultrasound (CEUS) is an imaging technique utilizing microbubble contrast agents to demonstrate blood flow and tissue perfusion. In this study, we performed a retrospective review to assess the utility of CEUS in the immediate post ablation detection of residual tumor.

METHODS:

Sixty-four ablations were retrospectively reviewed. 6/64 ablations (9.4%) had residual tumor on the first follow-up imaging after thermal ablation. There were two groups of patients. Group 1 underwent standard protocol thermal ablation with CT and/or ultrasound guidance. Group 2 not only had thermal ablation with a protocol identical to group 1, but also had CEUS assessment at the conclusion of the procedure to ensure satisfactory ablation zone.

RESULTS:

The residual tumor rate in group 1 was 16.7% and the residual tumor rate in group 2 was 0%. The difference between the groups was statistically significant with a p value of 0.023. The results suggest that using CEUS assessment immediately after the ablation procedure reduces the rate of residual tumor after thermal ablation.

CONCLUSION:

CEUS evaluation at the end of an ablation procedure is a powerful technique providing critical information to the treating interventional radiologist, without additional nephrotoxic contrast or ionizing radiation.

KEYWORDS:

Computed tomography (CT); Contrast-enhanced ultrasound (CEUS); Hepatocellular carcinoma (HCC); Radiofrequency ablation (RFA)

PMID:
26969495
DOI:
10.1007/s00261-016-0700-4
[Indexed for MEDLINE]

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