Monitoring after radiofrequency ablation of liver tumors: contrast-enhanced ultrasound (CEUS) vs. contrast-enhanced computer tomography (CECT), two days after procedure.

Eva Korcakova,Eva Korcakova,Vaclav Liska,Petr Hosek,Vaclav Liska,Kristyna Bajcurova,Kristyna Bajcurova,Hynek Mirka,Hynek Mirka

doi:10.5507/bp.2018.025

Eva Korcakova, Eva Korcakova + Show 7 more

Open Access

https://doi.org/10.5507/bp.2018.025

Copy DOI

Journal: Biomedical Papers	Publication Date: May 23, 2018
Citations: 2	License type: cc-by

Affiliation: Charles University

Abstract

Our research evaluated the ability of contrast-enhanced ultrasound (CEUS) and contrast enhanced computer tomography (CECT), performed 48 h after radiofrequency ablation (RFA), to detect residual tumor tissue. As recently published studies have evaluated periprocedural CEUS performed within 24 h after procedure and their results were not satisfactory, it seems that postponing the control test by one day could increase the sensitivity of both methods. We evaluated 33 patients with 37 lesions, who met the criteria for our study. The criteria were 1) the treated lesion is sonographically viewable and 2) the patient underwent both CEUS and CECT control 48 h after treatment and additional follow-up 3 months later by CECT. Presence of residual tumor tissue and the size of necrosis were recorded and compared to the results of 3-months CECT. Nine residues were present in our group. CEUS and CECT showed similar sensitivity (66.7% and 77.8%, respectively) and identical specificity (both 96.4%) for detection of residual tumor tissue. CEUS significantly underestimated the size of necrosis in comparison to CECT (on average by 2.4 mm, P=0.0005). Over the 3-months follow-up period the size of necrosis decreased in all patients (on average by 7.2 mm, P<0.0001). The quality of tumor residue detection in 48-h CEUS was comparable to that of 48-h CECT. This finding suggests the CEUS being a feasible substitute for CECT. Both methods show reasonable sensitivity; therefore this timing seems to be appropriate for the first post-treatment control while also allowing for early retreatment if residual tumor tissue is found.

Highlights

Primary liver tumors are the 5th most common tumor type in men and the 9th most common tumor type in women worldwide
Nine tumor residues were detected at the 3-months follow-up CECT. 48 h after ablation both methods agreed upon 5 of these residues
Sensitivity of CEUS was 66.7%, whereas specificity was 96.4% (81.7–99.9%)

Summary

Introduction

Primary liver tumors are the 5th most common tumor type in men and the 9th most common tumor type in women worldwide. The most common primary liver tumor is hepatocellular carcinoma (HCC). It occurs frequently in the Middle East Asia and Africa, where there is a high incidence of chronic hepatitis B and C and increased exposure to aflatoxins. Metastatic liver involvement is common, especially in cases of colorectal carcinoma (CRC) and breast carcinoma. The liver is the first site to which metastatic CRC spreads. 50-60% of patients with CRC develop liver metastases during their life. According to the World Health Organization (WHO) cancer report, in 2012 liver cancer was the second most common cause of cancer-related death worldwide[1]

Results

Discussion

Conclusion