Efficacy of Treatment on Liver Metastases by Contrast Enhanced Ultrasonography-Guided Percutaneous Radiofrequency Ablation_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WU Jie , YANG Wei , YIN Shanshan , WU Jinyu , WU Wei , YAN Kun , CHEN Minhua.

Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Ultrasound, Peking University Cancer Hospital &;
Institute, Beijing 100142, China;

Corresponding author：

Keywords：

Ultrasonography; Contrast medium; Liver metastasis; Radiofrequency ablation

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

ObjectiveTo evaluate the clinical application and the efficacy of contrast enhanced ultrasonography (CEUS)guided percutaneous radiofrequency ablation (RFA) in patients with liver metastases. MethodsTotal 136 patients with 219 liver metastatic tumors, which were detected by CEUS before RFA therapy, were analyzed retrospectively. The diamter of tumors was (3.2±1.2) cm. Among them, the largest tumor more than 3 cm in diameter were found in 48.5% (66 patients), and 57.4% (78 patients) were with solitary metastasis. Enhanced CT and (or) MRI, and laboratory tests were applied to evaluate the outcomes after RFA treatment by regular followup. ResultsTumors were not detected by conventional ultrasonography in two cases, and 47.0% (63/134) of the patients with the largest tumor were 0.3 cm larger by CEUS than by conventional ultrasonography. More 40 tumors were detected in 18.4% (25/136) patients by CEUS. Followup ranged from 3 to 68 months (median time of 12 months). Early tumor necrosis rate one month after therapy was 98.2% (215/219 tumors). The incidence of local recurrence, new intrahepatic metastasis, and extrahepatic metastasis was 16.9% (23/136), 38.2% (52/136), and 8.8% (12/136), respectively. Local recurrence and new intrahepatic metastasis happened 2-25 months (median time of 6 months) after treatment. Local recurrence rates of the largest tumors ≥ 3 cm and tumor lt; 3 cm was 22.7% and 11.4%， respectively (P=0.079). The rate of new intrahepatic metastasis for the solitary metastasis cases was significantly lower than that for multiple metastases cases (25.6% versus 55.2%, P=0.000). The 1, 2, 3year survival rates were 82.5%, 64.3%, and 50.1%, and the 1, 2, 3year local recurrence free survival rates were 67.7%, 53.8%, and 38.3%, respetively. Patients with solitary metastasis survived longer than that with multiple metastases (P=0.034). ConclusionPatients with liver metastases treated by CEUSguided percutaneous RFA can get better survival rate, and CEUS is of much value for clinic application.

Citation： WU Jie,YANG Wei,YIN Shanshan,WU Jinyu,WU Wei,YAN Kun,CHEN Minhua.. Efficacy of Treatment on Liver Metastases by Contrast Enhanced Ultrasonography-Guided Percutaneous Radiofrequency Ablation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(5): 479-484. doi: Copy

1.	Taylor M, Forster J, Langer B, et al. A study of prognosis factors for hepatic resection for colorectal metastases [J]. Am J Surg, 1997, 173（6）: 467471.
2.	Stang A, Keles H, von Seydewitz C, et al. Percutanous and intraoperative ultrasonography guided radiofrequency ablation of hepatic tumors [J]. Ultraschall Med, 2007, 28（2）: 181188.
3.	陈利平, 李宁. 肝癌的射频治疗 [J]. 中国普外基础与临床杂志, 2006, 13（4）: 482483.
4.	Solbiati L, Ierace T, Tonolini M, et al. Guidance and control of percutaneous treatments with contrastenhanced ultrasound [J]. Eur Radiol, 2003, 13（Suppl 3）: N87N90.
5.	Chen MH, Yang W, Yan K, et al. The role of contrastenhanced ultrasound in planning treatment protocols for hepatocellular carcinoma before radiofrequency ablation [J]. Clinical Radiology, 2007, 62（8）: 752760.
6.	Chen MH, Yang W, Yan K, et al. Large liver tumors: protocol for radiofrequency ablation and its clinical application in 110 patients mathematic model, overlapping mode and electrode placement process [J]. Radiology, 2004, 232（1）: 260271.
7.	Veltri A, Sacchetto P, Tosetti I, et al. Radiofrequency ablation of colorectal liver metastases: small size favorably predicts technique effectiveness and survival [J]. Cardiovasc Intervent Radiol, 2008, 31（5）: 948956.
8.	Gillams AR, Lees WR. Fiveyear survival following radiofrequency ablation of small, solitary hepatic colorectal metastases [J]. J Vasc Interv Radiol, 2008, 19（5）: 712717.
9.	Solbiati L, Goldberg SN, Lerace T, et al. Radiofrequency ablation of hepatic metastases: postprocedural assessment with a US microbubble contrast agentearly experience [J]. Radiology, 1999, 211（3）: 643649.
10.	Solbiati L, Tonolini M, Cova L. Monitoring RF ablation [J]. Eur Radiol, 2004, 14（suppl 8）: 3442.
11.	Minami Y, Kudo M, Kawasaki T, et al. Treatment of hepatocellular carcinoma with percutaneous radiofrequency ablation: usefulness of contrast harmonic sonography for lesions poorly defined with Bmode sonography [J]. Am J Roentgenol, 2004, 183（1）: 153156.
12.	DillMacky MJ, Asch M, Burns P, et al. Radiofrequency ablation of hepatocellular carcinoma: predicting success using contrastenhanced sonography [J]. Am J Roentgenol, 2006, 186（Suppl）: S287S295.
13.	武金玉, 陈敏华, 严昆, 等. 超声造影对肝转移癌射频消融的应用价值 [J]. 中华超声影像学杂志, 2008, 17（4）: 307311.
14.	廖锦堂, 潘瑞喆, 刘艳, 等. 超声造影评价肝癌射频消融治疗近期疗效 [J]. 中国普外基础与临床杂志, 2009, 16（4）: 265268.
15.	Sorensen SM, Mortensen FV, Nielsen DT. Radiofrequency of colorectal liver metastases: longterm survival [J]. Acta Radiol, 2007, 48（3）: 253258.
16.	Adam R, Pascal G, Castaing D, et al. Tumor progression while on chemotherapy: a contradication to liver resection for multiple colorectal metastases? [J]. Ann Surg, 2004, 240（6）: 10521061.
17.	Chen MH, Wu W, Yang W, et al. The use of contrastenhanced ultrasonography in the selection of patients with hepatocellular carcinoma for radio frequency ablation therapy [J]. J Ultrasound Med, 2007, 26（8）: 10551063.
18.	Wernecke K, Rummeny E, Bongartz G, et al. Detection of hepatic masses in patients with carcinoma: comparative sensitivities of sonography, CT, and MR imaging [J]. Am J Roentgenol, 1991, 157（4）: 731739.
19.	Clarke MP, Kane RA, Steele G Jr, et al. Prospective comparison of preoperative imaging and intraoperative ultrasonography in the detection of liver tumors [J]. Surgery, 1989, 106（5）: 849855.
20.	Gultekin S, Yucel C, Ozdemir H, et al . The role of latephase pulse in version harmonic imaging in the detection of occult hepatic metastases [J]. J Ultrasound Med, 2006, 25（9）: 11391145.
21.	尹珊珊, 陈敏华, 严昆, 等. 超声造影对肝转移癌的诊断价值 [J]. 中华超声影像学杂志, 2005, 14（5）: 354358.
22.	张晖, 杨薇, 高文, 等. 超声引导射频消融对136例肝转移性肿瘤的应用价值 [J]. 中华医学超声杂志（电子版）, 2005, 2（6）: 366369.
23.	Solbiati L, Livraghi T, Goldberg SN, et al. Percutaneous radiofrequency ablation of hepatic metastases from colorectal cancer: longterm results in 117 patients [J]. Radiology, 2001, 221（1）: 159166.

1. Taylor M, Forster J, Langer B, et al. A study of prognosis factors for hepatic resection for colorectal metastases [J]. Am J Surg, 1997, 173（6）: 467471.
2. Stang A, Keles H, von Seydewitz C, et al. Percutanous and intraoperative ultrasonography guided radiofrequency ablation of hepatic tumors [J]. Ultraschall Med, 2007, 28（2）: 181188.
3. 陈利平, 李宁. 肝癌的射频治疗 [J]. 中国普外基础与临床杂志, 2006, 13（4）: 482483.
4. Solbiati L, Ierace T, Tonolini M, et al. Guidance and control of percutaneous treatments with contrastenhanced ultrasound [J]. Eur Radiol, 2003, 13（Suppl 3）: N87N90.
5. Chen MH, Yang W, Yan K, et al. The role of contrastenhanced ultrasound in planning treatment protocols for hepatocellular carcinoma before radiofrequency ablation [J]. Clinical Radiology, 2007, 62（8）: 752760.
6. Chen MH, Yang W, Yan K, et al. Large liver tumors: protocol for radiofrequency ablation and its clinical application in 110 patients mathematic model, overlapping mode and electrode placement process [J]. Radiology, 2004, 232（1）: 260271.
7. Veltri A, Sacchetto P, Tosetti I, et al. Radiofrequency ablation of colorectal liver metastases: small size favorably predicts technique effectiveness and survival [J]. Cardiovasc Intervent Radiol, 2008, 31（5）: 948956.
8. Gillams AR, Lees WR. Fiveyear survival following radiofrequency ablation of small, solitary hepatic colorectal metastases [J]. J Vasc Interv Radiol, 2008, 19（5）: 712717.
9. Solbiati L, Goldberg SN, Lerace T, et al. Radiofrequency ablation of hepatic metastases: postprocedural assessment with a US microbubble contrast agentearly experience [J]. Radiology, 1999, 211（3）: 643649.
10. Solbiati L, Tonolini M, Cova L. Monitoring RF ablation [J]. Eur Radiol, 2004, 14（suppl 8）: 3442.
11. Minami Y, Kudo M, Kawasaki T, et al. Treatment of hepatocellular carcinoma with percutaneous radiofrequency ablation: usefulness of contrast harmonic sonography for lesions poorly defined with Bmode sonography [J]. Am J Roentgenol, 2004, 183（1）: 153156.
12. DillMacky MJ, Asch M, Burns P, et al. Radiofrequency ablation of hepatocellular carcinoma: predicting success using contrastenhanced sonography [J]. Am J Roentgenol, 2006, 186（Suppl）: S287S295.
13. 武金玉, 陈敏华, 严昆, 等. 超声造影对肝转移癌射频消融的应用价值 [J]. 中华超声影像学杂志, 2008, 17（4）: 307311.
14. 廖锦堂, 潘瑞喆, 刘艳, 等. 超声造影评价肝癌射频消融治疗近期疗效 [J]. 中国普外基础与临床杂志, 2009, 16（4）: 265268.
15. Sorensen SM, Mortensen FV, Nielsen DT. Radiofrequency of colorectal liver metastases: longterm survival [J]. Acta Radiol, 2007, 48（3）: 253258.
16. Adam R, Pascal G, Castaing D, et al. Tumor progression while on chemotherapy: a contradication to liver resection for multiple colorectal metastases? [J]. Ann Surg, 2004, 240（6）: 10521061.
17. Chen MH, Wu W, Yang W, et al. The use of contrastenhanced ultrasonography in the selection of patients with hepatocellular carcinoma for radio frequency ablation therapy [J]. J Ultrasound Med, 2007, 26（8）: 10551063.
18. Wernecke K, Rummeny E, Bongartz G, et al. Detection of hepatic masses in patients with carcinoma: comparative sensitivities of sonography, CT, and MR imaging [J]. Am J Roentgenol, 1991, 157（4）: 731739.
19. Clarke MP, Kane RA, Steele G Jr, et al. Prospective comparison of preoperative imaging and intraoperative ultrasonography in the detection of liver tumors [J]. Surgery, 1989, 106（5）: 849855.
20. Gultekin S, Yucel C, Ozdemir H, et al . The role of latephase pulse in version harmonic imaging in the detection of occult hepatic metastases [J]. J Ultrasound Med, 2006, 25（9）: 11391145.
21. 尹珊珊, 陈敏华, 严昆, 等. 超声造影对肝转移癌的诊断价值 [J]. 中华超声影像学杂志, 2005, 14（5）: 354358.
22. 张晖, 杨薇, 高文, 等. 超声引导射频消融对136例肝转移性肿瘤的应用价值 [J]. 中华医学超声杂志（电子版）, 2005, 2（6）: 366369.
23. Solbiati L, Livraghi T, Goldberg SN, et al. Percutaneous radiofrequency ablation of hepatic metastases from colorectal cancer: longterm results in 117 patients [J]. Radiology, 2001, 221（1）: 159166.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Efficacy of Treatment on Liver Metastases by Contrast Enhanced Ultrasonography-Guided Percutaneous Radiofrequency Ablation

Abstract Full text Figures/Tables Video References Cited by

Format

Content