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Impact of intraoperative sonography on resection and cryoablation of liver tumors
Author(s) -
Gaitini Diana,
Kopelman Doron,
Soudak Michal,
Epelman Monica,
Assalia Ahmad,
Hashmonai Moshe,
Engel Ahuva
Publication year - 2001
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.1032
Subject(s) - medicine , cryoablation , radiology , portography , cryosurgery , diaphragm (acoustics) , portal hypertension , ablation , cirrhosis , physics , acoustics , loudspeaker
Abstract Purpose We retrospectively analyzed the impact of intraoperative sonography (IOUS) on the management of patients referred for resection of liver tumors. Methods Forty patients underwent IOUS with a 7‐MHz curved‐array sector transducer; in selected cases, a 5‐MHz linear‐array transducer attached to a color Doppler unit was also used. The number, size, and location of tumors on IOUS, including tumor proximity to or invasion of major vessels or invasion of the diaphragm, were compared to findings on preoperative imaging studies. The effect of these findings on surgical management was assessed. Unresectable lesions were treated by cryoablation under ultrasound guidance. Results IOUS detected preoperatively unsuspected lesions in 7 patients (18%). Metastases suspected on CT arterial portography were ruled out in 2 patients (5%), and indeterminate lesions were diagnosed as cysts by IOUS in 2 other patients (5%). Vascular proximity or vascular or diaphragmatic invasion detected by IOUS rendered lesions unresectable in 4 patients (10%). Cryoablation under IOUS guidance and monitoring was attempted in 11 patients (28%) and performed successfully in 10. Conclusions IOUS changed the management in 38% of patients and guided cryoablation in 28% of patients. IOUS performed by an experienced sonologist is invaluable for the accurate assessment of liver tumor resectability; the detection of additional, preoperatively unknown lesions; and the guidance of cryoablation of unresectable tumors. © 2001 John Wiley & Sons, Inc. J Clin Ultrasound 29:265–272, 2001.