Microwave ablation of large HCC lesions: Added value of CEUS examinations for ablation success control
Issue title: Selected Presentations held at the 35th Conference of the German Society for Clinical Microcirculation and Hemorheology, Mainz, Germany, 4-5 November, 2016
Affiliations: Department of Radiology, University Hospital Regensburg, Regensburg, Germany
Correspondence:
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Corresponding author: Benedikt Pregler, Department of Radiology, University Hospital Regensburg, 93053 Regensburg, Germany. Tel.: +49 941 944 7401; E-mail: benedikt.pregler@ukr.de.
Abstract: PURPOSE: To assess the value of dynamic contrast enhanced ultrasound (CEUS) for the detection of residual tumor tissue day 1 after microwave ablation (MWA) of large hepatocellular carcinoma (HCC) compared to MRI. MATERIAL AND METHODS: 30 consecutive patients (5 females, 25 males, mean age 64 years, age range 54–73 years) with an untreated HCC lesion larger than or equal to 3 cm underwent percutaneous MWA between 03/2014 and 04/2016. 1 patient was excluded because of an artificial pacemaker. All remaining 29 patients underwent 3-T MRI with liver-specific contrast agent and CEUS 1 day after ablation to detect residual tumor tissue. The 6-week follow-up including CEUS and MRI was defined as the reference standard. RESULTS: Complete ablation was achieved in 23 of 29 treated lesions (79%). The sensitivities and specificities for the detection of residual tumor tissue on day 1 were 100% and 83% for CEUS and 87% and 67% for MRI resp. without the differences being statistically significant. CONCLUSION: CEUS allows a reliable assessment of therapeutic success of percutaneous ablation of large HCC lesions one day after the ablation. Its ability to visualize reactive periablation perfusion changes in real-time might be of advantage in the depiction of residual tumor tissue when compared to MRI imaging alone.
