Percutaneous irreversible electroporation of hepatocellular carcinoma: Contrast-enhanced ultrasound-findings during 1-year follow-up

Article type: Research Article

Authors: Niessen, C. | Beyer, L.P. | Haimerl, M. | Schicho, A.^{; *} | Stroszczynski, C. | Wiggermann, P. | Jung, E.M.

Affiliations: Institute for Radiology, University Hospital Regensburg, Regensburg, Germany

Correspondence: [*] Corresponding author: Dr. Andreas Schicho, University Hospital Regensburg, Institute for Radiology, Franz-Josef Strauss Allee 11, 93053 Regensburg, Germany. Tel.: +49 941 944 17409; Fax: +49 941 944 74 11; E-mail: andreas.schicho@ukr.de.

Abstract: PURPOSE:To assess the postprocedure findings after percutaneous irreversible electroporation (IRE) of hepatocellular carcinoma (HCC) in contrast-enhanced ultrasound (CEUS). MATERIALS AND METHODS:Percutaneous IRE was performed in a total of 22 patients with 24 HCC tumours following interdisciplinary tumour board review. The lesions were documented using CEUS before, immediately and within 24 hours after IRE. During follow-up CEUS was performed at 6 weeks and 3, 9, and 12 months after ablation. Two experienced radiologists evaluated the acquired CEUS image date in a consensus reading. RESULTS:Median tumour size before treatment was 13.7±4.8 mm (short axis) and 16.0±5.2 mm (long axis). All HCC lesions showed arterial hyperenhancement in CEUS. Median size of the ablation defect after ablation was 29.3±5.2 mm (short axis) and 31.6±5.6 mm (long axis). After IRE all tumours showed complete devascularization. The size of the ablation defects showed significant shrinkage and reduced peripheral enhancement in the course of follow-up. At 12 months follow-up the ablation defect size decreased to 16.7±4.3 mm (short axis) and 18.3±4.1 mm (long axis). CONCLUSION:CEUS showed a complete devascularization of HCC tumours after IRE. Post-intervetional peripheral enhancement returned to normal during follow-up and may represent zones of reversible damage of cellular integrity through electroporation. A significant shrinkage of the ablation defects during 12 month of follow-up was seen in all cases.

DOI: 10.3233/CH-180449

Journal: Clinical Hemorheology and Microcirculation, vol. 72, no. 1, pp. 85-93, 2019