DOI QR코드

DOI QR Code

Pretreatment Evaluation with Contrast-Enhanced Ultrasonography for Percutaneous Radiofrequency Ablation of Hepatocellular Carcinomas with Poor Conspicuity on Conventional Ultrasonography

  • Kim, Ah Yeong (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Min Woo (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Rhim, Hyunchul (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Cha, Dong Ik (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Choi, Dongil (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Young-sun (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lim, Hyo Keun (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Cho, Seong Whi (Department of Radiology, Kangwon National University College of Medicine)
  • 투고 : 2012.11.21
  • 심사 : 2013.07.02
  • 발행 : 2013.09.01

초록

Objective: To determine whether pretreatment evaluation with contrast-enhanced ultrasonography (CEUS) is effective for percutaneous radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC) with poor conspicuity on conventional ultrasonography (US). Materials and Methods: This retrospective study was approved by the institutional review board and informed consent was waived. From June 2008 to July 2011, 82 patients having HCCs (1.2 ${\pm}$ 0.4 cm) with poor conspicuity on planning US for RFA were evaluated with CEUS prior to percutaneous RFA. We analyzed our database, radiologic reports, and US images in order to determine whether the location of HCC candidates on planning US coincide with that on CEUS. To avoid incomplete ablation, percutaneous RFA was performed only when HCC nodules were identified on CEUS. The rate of technical success was assessed. The cumulative rate of local tumor progression was estimated with the use of the Kaplan-Meier method (mean follow-up: 24.0 ${\pm}$ 13.0 months). Results: Among 82 patients, 73 (89%) HCCs were identified on CEUS, whereas 9 (11%) were not. Of 73 identifiable HCCs on CEUS, the location of HCC on planning US corresponded with that on CEUS in 64 (87.7%), whereas the location did not correspond in 9 (12.3%) HCCs. Technical success was achieved for all 73 identifiable HCCs on CEUS in a single (n = 72) or two (n = 1) RFA sessions. Cumulative rates of local tumor progression were estimated as 1.9% and 15.4% at 1 and 3 years, respectively. Conclusion: Pretreatment evaluation with CEUS is effective for percutaneous RFA of HCCs with poor conspicuity on conventional US.

키워드

참고문헌

  1. Forner A, Llovet JM, Bruix J. Hepatocellular carcinoma. Lancet 2012;379:1245-1255 https://doi.org/10.1016/S0140-6736(11)61347-0
  2. European Association For The Study Of The Liver; European Organisation For Research And Treatment Of Cancer. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol 2012;56:908-943
  3. Bruix J, Sherman M; American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma: an update. Hepatology 2011;53:1020-1022 https://doi.org/10.1002/hep.24199
  4. Lee MW, Kim YJ, Park HS, Yu NC, Jung SI, Ko SY, et al. Targeted sonography for small hepatocellular carcinoma discovered by CT or MRI: factors affecting sonographic detection. AJR Am J Roentgenol 2010;194:W396-W400 https://doi.org/10.2214/AJR.09.3171
  5. Meloni MF, Goldberg SN, Livraghi T, Calliada F, Ricci P, Rossi M, et al. Hepatocellular carcinoma treated with radiofrequency ablation: comparison of pulse inversion contrastenhanced harmonic sonography, contrast-enhanced power Doppler sonography, and helical CT. AJR Am J Roentgenol 2001;177:375-380 https://doi.org/10.2214/ajr.177.2.1770375
  6. Goldberg SN, Gazelle GS, Compton CC, Mueller PR, Tanabe KK. Treatment of intrahepatic malignancy with radiofrequency ablation: radiologic-pathologic correlation. Cancer 2000;88:2452-2463 https://doi.org/10.1002/1097-0142(20000601)88:11<2452::AID-CNCR5>3.0.CO;2-3
  7. Min JH, Lee MW, Rhim H, Choi D, Kim YS, Kim YJ, et al. Recurrent hepatocellular carcinoma after transcatheter arterial chemoembolization: planning sonography for radio frequency ablation. J Ultrasound Med 2011;30:617-624
  8. Lee MW, Lim HK, Kim YJ, Choi D, Kim YS, Lee WJ, et al. Percutaneous sonographically guided radio frequency ablation of hepatocellular carcinoma: causes of mistargeting and factors affecting the feasibility of a second ablation session. J Ultrasound Med 2011;30:607-615
  9. Minami Y, Kudo M, Kawasaki T, Chung H, Ogawa C, Shiozaki H. Treatment of hepatocellular carcinoma with percutaneous radiofrequency ablation: usefulness of contrast harmonic sonography for lesions poorly defined with B-mode sonography. AJR Am J Roentgenol 2004;183:153-156 https://doi.org/10.2214/ajr.183.1.1830153
  10. Masuzaki R, Shiina S, Tateishi R, Yoshida H, Goto E, Sugioka Y, et al. Utility of contrast-enhanced ultrasonography with Sonazoid in radiofrequency ablation for hepatocellular carcinoma. J Gastroenterol Hepatol 2011;26:759-764 https://doi.org/10.1111/j.1440-1746.2010.06559.x
  11. Kudo M, Hatanaka K, Maekawa K. Newly developed novel ultrasound technique, defect reperfusion ultrasound imaging, using sonazoid in the management of hepatocellular carcinoma. Oncology 2010;78 Suppl 1:40-45
  12. Bruix J, Sherman M; Practice Guidelines Committee, American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma. Hepatology 2005;42:1208-1236 https://doi.org/10.1002/hep.20933
  13. Omata M, Lesmana LA, Tateishi R, Chen PJ, Lin SM, Yoshida H, et al. Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma. Hepatol Int 2010;4:439-474 https://doi.org/10.1007/s12072-010-9165-7
  14. Makuuchi M, Kokudo N, Arii S, Futagawa S, Kaneko S, Kawasaki S, et al. Development of evidence-based clinical guidelines for the diagnosis and treatment of hepatocellular carcinoma in Japan. Hepatol Res 2008;38:37-51 https://doi.org/10.1111/j.1872-034X.2007.00216.x
  15. Rhim H, Choi D, Kim YS, Lim HK, Choe BK. Ultrasonographyguided percutaneous radiofrequency ablation of hepatocellular carcinomas: a feasibility scoring system for planning sonography. Eur J Radiol 2010;75:253-258 https://doi.org/10.1016/j.ejrad.2009.04.014
  16. Song I, Rhim H, Lim HK, Kim YS, Choi D. Percutaneous radiofrequency ablation of hepatocellular carcinoma abutting the diaphragm and gastrointestinal tracts with the use of artificial ascites: safety and technical efficacy in 143 patients. Eur Radiol 2009;19:2630-2640 https://doi.org/10.1007/s00330-009-1463-x
  17. Rhim H, Lim HK. Radiofrequency ablation for hepatocellular carcinoma abutting the diaphragm: the value of artificial ascites. Abdom Imaging 2009;34:371-380 https://doi.org/10.1007/s00261-008-9408-4
  18. Goldberg SN, Grassi CJ, Cardella JF, Charboneau JW, Dodd GD 3rd, Dupuy DE, et al. Image-guided tumor ablation: standardization of terminology and reporting criteria. J Vasc Interv Radiol 2009;20(7 Suppl):S377-S390 https://doi.org/10.1016/j.jvir.2009.04.011
  19. Liu F, Yu X, Liang P, Cheng Z, Han Z, Dong B. Contrastenhanced ultrasound-guided microwave ablation for hepatocellular carcinoma inconspicuous on conventional ultrasound. Int J Hyperthermia 2011;27:555-562 https://doi.org/10.3109/02656736.2011.564262
  20. Solbiati L, Ierace T, Tonolini M, Cova L. Guidance and monitoring of radiofrequency liver tumor ablation with contrast-enhanced ultrasound. Eur J Radiol 2004;51 Suppl:S19-S23 https://doi.org/10.1016/j.ejrad.2004.03.035
  21. Wakui N, Takayama R, Kanekawa T, Ichimori M, Otsuka T, Shinohara M, et al. Usefulness of arrival time parametric imaging in evaluating the degree of liver disease progression in chronic hepatitis C infection. J Ultrasound Med 2012;31:373-382
  22. Minami Y, Kudo M, Hatanaka K, Kitai S, Inoue T, Hagiwara S, et al. Radiofrequency ablation guided by contrast harmonic sonography using perfluorocarbon microbubbles (Sonazoid) for hepatic malignancies: an initial experience. Liver Int 2010;30:759-764 https://doi.org/10.1111/j.1478-3231.2010.02226.x
  23. Moriyasu F, Itoh K. Efficacy of perflubutane microbubbleenhanced ultrasound in the characterization and detection of focal liver lesions: phase 3 multicenter clinical trial. AJR Am J Roentgenol 2009;193:86-95 https://doi.org/10.2214/AJR.08.1618
  24. Hatanaka K, Kudo M, Minami Y, Ueda T, Tatsumi C, Kitai S, et al. Differential diagnosis of hepatic tumors: value of contrastenhanced harmonic sonography using the newly developed contrast agent, Sonazoid. Intervirology 2008;51 Suppl 1:61-69 https://doi.org/10.1159/000122600

피인용 문헌

  1. Radiofrequency ablation of very-early-stage hepatocellular carcinoma inconspicuous on fusion imaging with B-mode US: value of fusion imaging with contrast-enhanced US vol.20, pp.1, 2013, https://doi.org/10.3350/cmh.2014.20.1.61
  2. Ultrasound-Guided Percutaneous Radiofrequency Ablation of Liver Tumors: How We Do It Safely and Completely vol.16, pp.6, 2013, https://doi.org/10.3348/kjr.2015.16.6.1226
  3. Local ablation therapy with contrast-enhanced ultrasonography for hepatocellular carcinoma: a practical review vol.34, pp.4, 2015, https://doi.org/10.14366/usg.15018
  4. Contrast-enhanced ultrasound-guided percutaneous microwave ablation of renal cell carcinoma that is inconspicuous on conventional ultrasound vol.32, pp.6, 2013, https://doi.org/10.3109/02656736.2016.1172118
  5. Noninvasive Diagnosis of Hepatocellular Carcinoma: Elaboration on Korean Liver Cancer Study Group-National Cancer Center Korea Practice Guidelines Compared with Other Guidelines and Remaining Issues vol.17, pp.1, 2016, https://doi.org/10.3348/kjr.2016.17.1.7
  6. Comparison of real-time contrast-enhanced ultrasonography and standard ultrasonography in liver cancer microwave ablation vol.12, pp.3, 2016, https://doi.org/10.3892/etm.2016.3448
  7. Combined transarterial chemoembolization and radiofrequency ablation for small treatment-naïve hepatocellular carcinoma infeasible for ultrasound-guided radiofrequency ablation: long-term outcome vol.59, pp.7, 2018, https://doi.org/10.1177/0284185117735349
  8. Contrast‐enhanced ultrasound for hepatocellular carcinoma: Focusing on unique benefits and indications vol.6, pp.1, 2019, https://doi.org/10.1002/aid2.13111
  9. Contrast-enhanced ultrasound of hepatocellular carcinoma: where do we stand? vol.38, pp.3, 2013, https://doi.org/10.14366/usg.18060
  10. Ultrasound fusion imaging technologies for guidance in ablation therapy for liver cancer vol.47, pp.2, 2013, https://doi.org/10.1007/s10396-020-01006-w
  11. Ultrasound fusion imaging technologies for guidance in ablation therapy for liver cancer vol.48, pp.6, 2013, https://doi.org/10.3179/jjmu.jjmu.r.183
  12. Image Guidance in Ablation for Hepatocellular Carcinoma: Contrast-Enhanced Ultrasound and Fusion Imaging vol.11, pp.None, 2013, https://doi.org/10.3389/fonc.2021.593636