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Fusion imaging with contrast‑enhanced ultrasonography for evaluating the early therapeutic efficacy of radiofrequency ablation for small hypervascular hepatocellular carcinomas with iso‑echoic or unclear margins on conventional ultrasonography

西郡 修平 横浜市立大学

2021.02.28

概要

Purpose
We evaluated the efcacy of fusion imaging combining contrast-enhanced ultrasonography (CEUS) images and arterial phase contrast-enhanced CT (CECT) or hepatobiliary phase magnetic resonance imaging with gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (EOB-MRI) images for the early evaluation of the efectiveness of radiofrequency ablation (RFA) for small hypervascular hepatocellular carcinoma (HCC) with iso-echoic or unclear margins on conventional US.

Methods
Forty HCCs (22 iso-echoic and 18 unclear margin lesions) with mean diameters of 13.7 mm were treated using RFA under the guidance of fusion imaging with CEUS. The adequacy of RFA was evaluated using fusion imaging with CEUS 1 day after RFA. CECT or EOB-MRI was performed 1 month after RFA. We reviewed the images obtained using both modalities.

Results
When the 1-month CECT or EOB-MRI scans were used as the reference standard, the sensitivity, specifcity, and accuracy of the 1-day fusion imaging for the diagnosis of the adequate ablation of these HCCs were 97, 100, and 98%, respectively; the kappa value for the agreement between the fndings using the two modalities was 0.655.

Conclusion
Fusion imaging with CEUS appears to be a useful method for the early evaluation of the efcacy of RFA for the treatment of HCCs with iso-echoic or unclear margins on conventional US.

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参考文献

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