Document Detail


Contrast-enhanced ultrasonography (CEUS) immediately after percutaneous ablation of hepatocellular carcinoma.
MedLine Citation:
PMID:  19756947     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: This study evaluated the effectiveness of contrast-enhanced ultrasound (CEUS), performed immediately after percutaneous ethanol injection (PEI) or radiofrequency thermal ablation (RFTA), by comparing results with the computed tomography (CT) follow-up. MATERIALS AND METHODS: Sixty-nine consecutive patients with a diagnosis of hepatocellular carcinoma (HCC) were included in this prospective study. All patients underwent PEI or RFTA. After treatment, three CEUS enhancement patterns were observed: isovascular, hypovascular and avascular, which were compared with the CT findings. Sensitivity of the avascular pattern at CEUS and effectiveness of the ablative procedures were evaluated and compared with the chi-square test. RESULTS: Ninety hypervascular HCCs, with a mean diameter of 2.6 cm (0.5-4.9 cm), underwent PEI (n=54) and RFTA (n=36). In the first group, CT identified complete necrosis in 28/54 (52%) lesions, 21 (75%) of which had avascular, one (4%) isovascular and six (21%) hypovascular patterns at CEUS. In the second group, CT showed complete necrosis in 31/36 (86%) lesions, all (100%) of which had a corresponding avascular pattern at CEUS. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the avascular pattern at CEUS compared with CT findings were 75%, 69%, 72%, 72% and 72% for PEI and 100%, 20%, 89%, 100% and 89%, for RFTA, respectively. A statistically significant difference (p<0.05) between the sensitivity of CEUS after PEI and after RFTA and between the necrosis obtained by RFTA and PEI were observed. CONCLUSIONS: CEUS performed immediately after percutaneous ablation of hepatocellular carcinoma to evaluate treatment efficacy is compulsory in the case of RFTA but not for PEI.
Authors:
A Gallotti; M D'Onofrio; A Ruzzenente; E Martone; R De Robertis; A Guglielmi; R Pozzi Mucelli
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-09-05
Journal Detail:
Title:  La Radiologia medica     Volume:  114     ISSN:  1826-6983     ISO Abbreviation:  Radiol Med     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2010-01-21     Completed Date:  2010-02-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0177625     Medline TA:  Radiol Med     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  1094-105     Citation Subset:  IM    
Affiliation:
Istituto di Radiologia, Policlinico G.B. Rossi, Universit? di Verona, Verona, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Algorithms
Carcinoma, Hepatocellular / pathology*,  radiography,  surgery,  ultrasonography*
Catheter Ablation / methods*
Contrast Media / diagnostic use
Ethanol / administration & dosage
Female
Follow-Up Studies
Humans
Injections, Intralesional
Liver Neoplasms / pathology*,  radiography,  surgery,  ultrasonography*
Male
Middle Aged
Necrosis
Postoperative Period
Predictive Value of Tests
Prospective Studies
Sensitivity and Specificity
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Ultrasonography, Interventional* / methods
Chemical
Reg. No./Substance:
0/Contrast Media; 64-17-5/Ethanol

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