Use of intra-procedural fusion imaging combining contrast-enhanced ultrasound using a perflubutane-based contrast agent and auto sweep three-dimensional ultrasound for guiding radiofrequency ablation and evaluating its efficacy in patients with hepatocellular carcinoma. (1st January 2020)

• Record Type: Journal Article
• Authors: Sanga, Katsuyuki; Numata, Kazushi; Nihonmatsu, Hiromi; Ogushi, Katsuaki; Fukuda, Hiroyuki; Chuma, Makoto; Hashimoto, Hiroshi; Koizumi, Norihiro; Maeda, Shin
• Is Part Of: International journal of hyperthermia. Volume 37:Number 1(2020)
• Page Start: 202
• Page End: 211
• Publication Date: 2020-01-01
• Subjects: Fusion imaging -- contrast-enhanced ultrasound -- perflubutane-based contrast agent -- hepatocellular carcinoma -- radiofrequency ablation; Thermotherapy -- Periodicals; 615.832
• DOI: 10.1080/02656736.2020.1729422
• Languages: English
• ISSNs: 0265-6736

Abstract

Abstract: Purpose: This study evaluated the usefulness of intraprocedural contrast-enhanced ultrasound (CEUS)/ultrasound (US) fusion imaging using a perflubutane-based contrast agent combined with preprocedural auto sweep three-dimensional US to obtain volume data for guidance and evaluation of the therapeutic efficacy of radiofrequency ablation (RFA). Methods: This uncontrolled clinical trial included 50 hepatocellular carcinomas (HCCs) with a mean diameter of 15.3 mm that had been treated by RFA. The efficacy of RFA was evaluated by CEUS/US fusion imaging during the procedure. If the ablation was deemed to be inadequate, further ablation was performed until adequate ablation was achieved. Contrast-enhanced computed tomography (CECT) or contrast-enhanced magnetic resonance imaging (CEMRI) was performed a month after RFA, and the images obtained using each modality were reviewed to evaluate the efficacy of RFA. Results: Thirty-three of the 50 lesions were evaluated by CEUS/US fusion imaging as having been adequately ablated after the first RFA procedure. The ablation was evaluated as inadequate in the remaining 17 lesions, for which additional ablation was performed. Ninety-eight (49/50) of all HCCs were evaluated as having been eventually adequately ablated on intraprocedural CEUS/US fusion imaging. The concordance rate for evaluations between intraprocedural CEUS/US fusion imaging and CECT/CEMRI performed 1 month after RFA was 88% (44/50). The kappa value for agreement between the two methods of evaluation was 0.792. Conclusion: Intraprocedural fusion imaging combining CEUS and auto sweep three-dimensional US appears to be a useful modality for RFA guidance and evaluation of therapeutic efficacy of RFA in patients with HCC.