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Intra‐operative contrast‐enhanced ultrasound improves image enhancement in the evaluation of liver tumors
Author(s) -
Martin Robert C.G.,
Reuter Nathan P.,
Woodall Charles
Publication year - 2010
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21511
Subject(s) - medicine , ultrasound , echogenicity , sedation , bolus (digestion) , radiology , contrast enhanced ultrasound , contrast enhancement , dosing , prospective cohort study , nuclear medicine , surgery , magnetic resonance imaging
Background Intra‐operative hepatic tumor ultrasound assessment can be difficult in patients with abnormal hepatic parenchyma because of the inability to enhance echogenic differences. Methods Prospective pilot study of intra‐operative ultrasound contrast enhancement in the evaluation of liver tumors to establish safety, dosing, and increased image enhancement with ultrasound contrast evaluation. A single bolus of perfluten lipid microspheres was then injected and ultrasound images were then re‐recorded and saved. Results Twenty consecutive patients underwent contrast‐enhanced ultrasound evaluation during the operative procedure. All patients received at least one bolus dose of microspheres (median 2 dose, range 1–3), without change in heart rate, blood pressure, end tidal CO 2 , oxygen saturation, and sedation monitoring at the time of dosing and until 4 hr post‐bolus doses. Two blinded independent readers found the contrasted images to have a statistically greater degree of enhancement (median improvement of 4, P = 0.01) and greater degree of size/border characteristics in the contrasted images (median improvement of 5, P = 0.01) for all histologies. In five patients, the extent of hepatic resection was altered from partial to complete lobectomy in order to obtain acceptable oncologic margin. Conclusions Contrast‐enhanced ultrasound is safe and effective in pre‐resection and pre‐ablation treatment planning. J. Surg. Oncol. 2010; 101:370–375. © 2010 Wiley‐Liss, Inc.