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Assessment of Therapeutic Response in Hepatocellular Carcinoma Treated With Percutaneous Radio Frequency Ablation
Author(s) -
Choi Dongil,
Lim Hyo K.,
Kim Seung Hoon,
Lee Won Jae,
Jang Hyun-Jung,
Kim Hana,
Lee Soon Jin,
Lim Jae Hoon
Publication year - 2002
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/jum.2002.21.4.391
Subject(s) - medicine , hepatocellular carcinoma , radiology , ablation , doppler effect , ultrasonography , computed tomography , ultrasound , bolus (digestion) , nuclear medicine , tomography , surgery , physics , astronomy
Objectives To compare the results of multiphase helical computed tomography and power Doppler ultrasonography with a microbubble contrast agent in the assessment of the therapeutic response to radio frequency ablation in hepatocellular carcinoma. Methods In 66 patients with 73 nodular hepatocellular carcinomas ranging from 1.0 to 4.0 cm (mean, 2.6 cm) in diameter, contrast‐enhanced power Doppler ultrasonography was performed after intravenous bolus injection of a galactose‐based microbubble contrast agent before and after radio frequency ablation. The results of the studies were compared with the findings of follow‐up 3‐phase helical computed tomography. All patients were regularly followed up with computed tomography for more than 1 year (range, 13–19 months). Results In 8 (11%) of 73 hepatocellular carcinomas, immediate follow‐up computed tomography obtained within 2 hours after radio frequency ablation showed focal enhancing portions within the treated lesions, suggesting residual non‐necrotic tumors. All 8 of these tumors had intratumoral flow signals on contrast‐enhanced power Doppler ultrasonography. The diagnostic agreement between computed tomography and contrast‐enhanced power Doppler ultrasonography was achieved in 100%. Among the remaining 65 hepatocellular carcinomas with the absence of residual tumors at both immediate follow‐up computed tomography and contrast‐enhanced power Doppler ultrasonography, subsequent follow‐up computed tomography showed local regrowth at the margins of 10 lesions (15%). Conclusions The results of contrast‐enhanced power Doppler ultrasonography closely correlated with those of immediate follow‐up computed tomography for detecting residual tumors in hepatocellular carcinomas treated with radio frequency ablation. Both techniques, however, showed a limitation in detecting small or microscopic residual tumors and in predicting local regrowth in the treated lesions.