Virtual navigation assisted 3-D contrast-enhanced ultrasound in evaluating ablative margin after radiofrequency ablation

Abstract

Objective To evaluate the value of virtual navigation assisted 3-D contrast-enhanced ultrasound (VNA-3D-CEUS) in depicting ablative area and ablative margin after hepatocellular carcinoma radiofrequency ablation. Methods Sixty-one lesions in 51 patients were evaluated ablative area and ablative margin using VNA-3D-CEUS. The results were divided into three groups: (A) tumor was completely ablated and 5 mm ablative margin was achieved; (B) tumor was completely ablated but 5 mm ablative margin was not achieved; (C) tumor was not completely ablated. The technical successful rate of VNA-3D-CEUS,as well as the coincidence rate of complete ablation with contrast-enhanced MRI,was evaluated. The relation between local tumor progression and ablative margin was observed through follow-up. Results The technical successful rate of VNA-3D-CEUS was 78.7％ (48/61). Coincidence rate of complete ablation with contrast-enhanced MRI was 100％ (40/40). The local tumor progressions of group A and group B were 0/26 and 2/13. There was significant difference between A and B group( P =0.032). Significant correlation between local tumor progression and ablative margin was found ( r =- 1. 000, P ＜0. 001 ). Conclusions VNA-3D-CEUS could be a new method in accurately evaluating the ablative area and ablative margin after hepatocellular carcinoma ablation. Key words: Ultrasonography, three-dimensional ; Microbubbles ; Liver neoplasms ; Catheter ablation; Virtual navigation