Comparison between CT/MR-contrast enhanced ultrasound image fusion and contrast enhanced ultrasound in immediate assessment for hepatocellular carcinoma ablation

Abstract

Objective To evaluate the clinical value of CT/MR-contrast enhanced ultrasound (CEUS) image fusion in immediate assessment for hepatocellular carcinoma(HCC) ablation. Methods Patients diagnosed with HCC to receive ablation therapy were randomly divided into two groups. The ablation for each patient was performed according to their pre-ablation plan. Immediate assessments for the ablation were performed using CT/MR-CEUS image fusion (IF group) and CEUS (CEUS group) separately and whether the need for additional ablations was decided and performed during the therapy. The therapy efficacy was evaluated with enhanced CT or MR 1 month after each complete ablation treatment. Results There were 101 patients with 131 nodules in IF group, and 15.1% of the nodules needed additional ablation according the immediate assessment during the therapy. The complete ablation rate of IF group was 99.2% (125/126). On the other hand, there were 93 patients with 122 nodules in CEUS group, and 4.2% of the nodules needed additional ablation according the immediate assessment during the therapy. The complete ablation rate of CEUS group was 94.2% (113/120). IF group has significantly higher additional ablation rate and complete ablation rate than CEUS group (P<0.05). Conclusions CT/MR-CEUS image fusion can further improve ablation efficacy with accurate intraoperative evaluation and guidance of additional ablation compared with CEUS. Key words: Ultrasonography; Image fusion; Microbubbles; Carcinoma, hepatocellular; Catheter ablation