Assessment of Short Term Therapeutic Response to Radiofrequency Ablation by Contrast Enhanced Ultrasound in Hepatocellular Carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIAO Jintang ¹ , PAN Ruizhe ¹ , LIU Yan ¹ , GUO Mengan ¹ , WANG Zhiming ² , ZHOU Ledu ² , CAO Jue ³ , XIAO Ying ¹

1.Department of Ultrasound;;
2.Department of General Surgery;;
3.Department of Radiology;;
Xiangya Hospital, Central South University, Changsha 410008, ChinaCorresponding Author: LIAO Jin-tang, E-mail: liaojintang@hotmail.com;

Corresponding author：

Keywords：

Hepatocellular carcinoma; Radiofrequency ablation; Contrast enhanced ultrasound; Contrast enhanced computed tomography

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Objective 　To investigate the value of contrast enhanced ultrasound (CEUS) in evaluating the short term therapeutic response to radiofrequency ablation (RFA) of primary hepatocellular carcinoma.
Methods 　One hundred and ten lesions were studied in 96 patients. Each patient underwent CEUS within a week before RFA, the number, size, border, inner echo and perfusion pattern of lesions were observed. One month after ultrasound-guided RFA, color Doppler flow imaging, CEUS and contrast enhanced computed tomography (CECT, reference standard) were performed to assess the therapeutic response.
Results 　Before RFA, in 96 cases with 110 lesions, 83 lesions showed homogeneous hyper-enhancement and the other 27 heterogeneous hyper-enhancement in arterial phase, and 98 lesions were hypo-enhanced in portal venous phase and late phase and the other 12 iso-enhanced. One month after RFA, 99 of 110 lesions were found no-enhancement in entire CEUS procedure, while 11 lesions showed local enhancement on the edge of lesion. Ninety-six of 110 lesions showed no-enhancement and other 14 with irregular enhancement by CECT. There was no statistical significance between CEUS and CECT (χ2=0.406, P gt;0.05). Fourteen lesions as tumor residual by CECT were underwent RFA again, and then 1 month after RFA no-enhancement was showed by both CECT and CEUS.
Conclusion 　CEUS can play a role in assessing the short term therapeutic response to RFA of hepatocellular carcinoma.

Citation： LIAO Jintang,PAN Ruizhe,LIU Yan,GUO Mengan,WANG Zhiming,ZHOU Ledu,CAO Jue,XIAO Ying. Assessment of Short Term Therapeutic Response to Radiofrequency Ablation by Contrast Enhanced Ultrasound in Hepatocellular Carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(4): 265-268. doi: Copy

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2.	严昆，陈敏华，杨薇，等. 超声造影评价肝恶性肿瘤射频治疗疗效——与常规超声及增强CT比较 [J]. 中华超声影像学杂志, 2005； 14(9): 655658.
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8.	〖ＪＰ2〗李锐，张晓航，张萍, 等. 实时超声造影在肝癌射频消融治疗前的应用研究 [J]. 临床超声医学杂志， 2007； 9(3): 129131.〖ＪＰ〗.
9.	赵芳，张钧，祝英乔，等. 超声造影与增强CT评价肝癌射频消融疗效的研究 [J]. 中国超声医学杂志， 2006； 22(2): 125127.
10.	Hotta N, Tagaya T, Maeno T, et al. Advanced dynamic flow imaging with contrastenhanced ultrasonography for the evaluation of tumor vascularity in liver tumors [J]. Clin Imaging, 2005; 29(1): 3441.
11.	杜锡林，马庆久，褚延魁，等. 射频消融(RFA)治疗肝癌的临床研究 [J]. 肝胆外科杂志， 2008； 16(4): 260262.
12.	任正刚. 原发性肝癌的射频毁损治疗进展 [J]. 中国普外基础与临床杂志， 2007； 14(1): 57.
13.	Verhoef C, Kuiper JW, Heisterkamp J, et al. Interstitial laser coagulation with temporary hepatic artery occlusion for patients with cirrhosis and irresectable hepatoma [J]. Br J Surg, 2003; 90(8): 950955.
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16.	Wen YL, Kudo M, Zheng RQ, et al. Radiofrequency ablation of hepatocellular carcinoma: therapeutic response using contrastenhanced coded phaseinversion harmonic sonography [J]. AJR Am J Roentgenol, 2003; 181(1): 5763.
17.	Kim CK, Choi D, Lim HK, et al. Therapeutic response assessment of percutaneous radiofrequency ablation for hepatocellular carcinoma: utility of contrastenhanced agent detection imaging [J]. Eur J Radiol, 2005; 56(1): 6673.
18.	Vilana R, Bianchi L, Varela M, et al. Is microbubbleenhanced ultrasonography sufficient for assessment of response to percutaneous treatment in patients with early hepatocellular carcinoma? [J]. Eur Radiol, 2006; 16(11): 24542462.
19.	梁惠宏, 谭国胜, 张耀军，等. 兔VX2肝肿瘤射频消融疗效评价——超声造影、增强CT与病理对比研究 [J]. 临床放射学杂志， 2008； 27(7): 961964.
20.	罗葆明，钟文景，杨海云，等. 容积超声造影对肝肿瘤射频消融效果的评估 [J]. 中国医学影像技术， 2008； 24(1): 9597.

1. Solbiati L, Ierace T, Tonolini M, et al. Guidance and monitoring of radiofrequency liver tumor ablation with contrastenhanced ultrasound [J]. Eur J Radiol, 2004; 51 Suppl: S19S23.
2. 严昆，陈敏华，杨薇，等. 超声造影评价肝恶性肿瘤射频治疗疗效——与常规超声及增强CT比较 [J]. 中华超声影像学杂志, 2005； 14(9): 655658.
3. Albrecht T, Blomley M, Bolondi L, et al. Guidelines for the use of contrast agents in ultrasound. January 2004 [J]. Ultraschall Med, 2004; 25(4): 249256.
4. 丁红，王文平，黄备健，等. 超声造影检测和诊断小肝癌的价值 [J]. 中国普外基础与临床杂志， 2007； 14(1): 2831.
5. 戴琳，冯筱榕，陈永鹏，等. 超声、超声造影及多层螺旋CT 对小肝癌的影像学诊断 [J]. 南方医科大学学报， 2008； 28(8): 14691471.
6. 罗葆明，段红艳，文艳玲，等. 低机械指数谐波超声造影评估肝细胞癌介入治疗效果 [J]. 中华医学超声杂志(电子版)， 2006； 3(4): 234236.
7. 陈敏华，杨薇，严昆，等. 超声造影对确定肝癌射频消融范围及治疗策略的应用价值 [J]. 中华超声影像学杂志， 2006； 15(3): 193197.
8. 〖ＪＰ2〗李锐，张晓航，张萍, 等. 实时超声造影在肝癌射频消融治疗前的应用研究 [J]. 临床超声医学杂志， 2007； 9(3): 129131.〖ＪＰ〗.
9. 赵芳，张钧，祝英乔，等. 超声造影与增强CT评价肝癌射频消融疗效的研究 [J]. 中国超声医学杂志， 2006； 22(2): 125127.
10. Hotta N, Tagaya T, Maeno T, et al. Advanced dynamic flow imaging with contrastenhanced ultrasonography for the evaluation of tumor vascularity in liver tumors [J]. Clin Imaging, 2005; 29(1): 3441.
11. 杜锡林，马庆久，褚延魁，等. 射频消融(RFA)治疗肝癌的临床研究 [J]. 肝胆外科杂志， 2008； 16(4): 260262.
12. 任正刚. 原发性肝癌的射频毁损治疗进展 [J]. 中国普外基础与临床杂志， 2007； 14(1): 57.
13. Verhoef C, Kuiper JW, Heisterkamp J, et al. Interstitial laser coagulation with temporary hepatic artery occlusion for patients with cirrhosis and irresectable hepatoma [J]. Br J Surg, 2003; 90(8): 950955.
14. Tsuda M, Majima K, Yamada T, et al. Hepatocellular carcinoma after radiofrequency ablation therapy: dynamic CT evaluation of treatment [J]. Clin Imaging, 2001; 25(6): 409415.
15. 叶永强，马宽生，李锐，等. 超声造影监测原发性肝癌射频消融术的疗效 [J]. 中华普通外科杂志， 2006； 21(9): 650653.
16. Wen YL, Kudo M, Zheng RQ, et al. Radiofrequency ablation of hepatocellular carcinoma: therapeutic response using contrastenhanced coded phaseinversion harmonic sonography [J]. AJR Am J Roentgenol, 2003; 181(1): 5763.
17. Kim CK, Choi D, Lim HK, et al. Therapeutic response assessment of percutaneous radiofrequency ablation for hepatocellular carcinoma: utility of contrastenhanced agent detection imaging [J]. Eur J Radiol, 2005; 56(1): 6673.
18. Vilana R, Bianchi L, Varela M, et al. Is microbubbleenhanced ultrasonography sufficient for assessment of response to percutaneous treatment in patients with early hepatocellular carcinoma? [J]. Eur Radiol, 2006; 16(11): 24542462.
19. 梁惠宏, 谭国胜, 张耀军，等. 兔VX2肝肿瘤射频消融疗效评价——超声造影、增强CT与病理对比研究 [J]. 临床放射学杂志， 2008； 27(7): 961964.
20. 罗葆明，钟文景，杨海云，等. 容积超声造影对肝肿瘤射频消融效果的评估 [J]. 中国医学影像技术， 2008； 24(1): 9597.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Assessment of Short Term Therapeutic Response to Radiofrequency Ablation by Contrast Enhanced Ultrasound in Hepatocellular Carcinoma

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