Guidance of Percutaneous Tumor Ablation Procedures

Diagnostic imaging plays a key role in all steps of radiofrequency (RF) tumor ablation. It is used in the following ways: 1) detection of lesions and selection of patients for treatment; 2) targeting of lesions and guidance of the procedure; 3) immediate assessment of treatment results; 4) long-term follow-up. Conventional, unenhanced ultrasound (US) is widely employed for screening liver disease, but variable sensitivity and well-known drawbacks limit its role in the staging of liver tumors. Furthermore, sonography represents the most commonly used imaging modality for the guidance of percutaneous ablative treatments owing to its availability, rapidity and ease of use. Differentiation of induced necrosis from a viable tumor is not possible with baseline and color Doppler sonography and therefore the immediate and long-term assessment of the therapeutic result is usually accomplished by contrastenhanced helical computer tomography (CT) and magnetic resonance (MR). In our experience, the use of contrastenhanced ultrasound (CEUS) represents a significant improvement over conventional US for each of above-mentioned steps and has proven useful in achieving optimal patient management and treatment results [1].

[1]  Carlo Bartolozzi,et al.  Tissue harmonic and contrast-specific imaging: back to gray scale in ultrasound , 2002, European Radiology.

[2]  G. Gazelle,et al.  Thermal ablation therapy for focal malignancy: a unified approach to underlying principles, techniques, and diagnostic imaging guidance. , 2000, AJR. American journal of roentgenology.

[3]  A. Alavi,et al.  FDG Positron Emission Tomography in the Surveillance of Hepatic Tumors Treated with Radiofrequency Ablation , 2003, Clinical nuclear medicine.

[4]  G. Dodd,et al.  Tumor recurrence after radiofrequency thermal ablation of hepatic tumors: spectrum of findings on dual-phase contrast-enhanced CT. , 2001, AJR. American journal of roentgenology.

[5]  P. Ros,et al.  CT and MR imaging of hepatic metastases. , 2000, AJR. American journal of roentgenology.

[6]  P. Petrow,et al.  Hepatic tumors treated with percutaneous radio-frequency ablation: CT and MR imaging follow-up. , 2002, Radiology.

[7]  K J Wolf,et al.  Phase-inversion sonography during the liver-specific late phase of contrast enhancement: improved detection of liver metastases. , 2001, AJR. American journal of roentgenology.

[8]  T. de Baère,et al.  Radiofrequency ablation of 100 hepatic metastases with a mean follow-up of more than 1 year. , 2000, AJR. American journal of roentgenology.

[9]  Thomas Albrecht,et al.  Improved detection of hepatic metastases with pulse-inversion US during the liver-specific phase of SHU 508A: multicenter study. , 2003, Radiology.

[10]  C. Harvey,et al.  Ultrasound of focal liver lesions , 2001, European Radiology.

[11]  T. Livraghi,et al.  Small hepatocellular carcinoma treated with percutaneous RF ablation: MR imaging follow-up. , 1999, AJR. American journal of roentgenology.

[12]  D O Cosgrove,et al.  Hepatic malignancies: improved detection with pulse-inversion US in late phase of enhancement with SH U 508A-early experience. , 2000, Radiology.

[13]  M. Di Stasi,et al.  Percutaneous radiofrequency ablation of small hepatocellular carcinoma: long-term results , 2001, European Radiology.

[14]  L Solbiati,et al.  Hepatic metastases: percutaneous radio-frequency ablation with cooled-tip electrodes. , 1997, Radiology.

[15]  G. Gazelle,et al.  Hepatocellular carcinoma: radio-frequency ablation of medium and large lesions. , 2000, Radiology.

[16]  C. Bartolozzi,et al.  Radiofrequency thermal ablation of hepatocellular carcinoma: using contrast-enhanced harmonic power doppler sonography to assess treatment outcome. , 2001, AJR. American journal of roentgenology.

[17]  M. Kudo,et al.  Evaluation of posttreatment response of hepatocellular carcinoma with contrast-enhanced coded phase-inversion harmonic US: comparison with dynamic CT. , 2001, Radiology.

[18]  M. Locatelli,et al.  Detection of liver metastases by pulse inversion harmonic imaging during Levovist late phase: comparison with conventional ultrasound and helical CT in 160 patients , 2003, European Radiology.

[19]  E F Halpern,et al.  Percutaneous radio-frequency ablation of hepatic metastases from colorectal cancer: long-term results in 117 patients. , 2001, Radiology.

[20]  G. Gazelle,et al.  Percutaneous radio-frequency ablation of liver metastases from breast cancer: initial experience in 24 patients. , 2001, Radiology.

[21]  L Solbiati,et al.  Radio-frequency ablation of hepatic metastases: postprocedural assessment with a US microbubble contrast agent--early experience. , 1999, Radiology.

[22]  G. Dodd,et al.  Sonographically observed echogenic response during intraoperative radiofrequency ablation of cirrhotic livers: pathologic correlation. , 2002, AJR. American journal of roentgenology.

[23]  J. Figueras,et al.  Hepatic metastases from colorectal cancer: preoperative detection and assessment of resectability with helical CT. , 2001, Radiology.

[24]  S. Goldberg,et al.  Hepatocellular carcinoma treated with radiofrequency ablation: comparison of pulse inversion contrast-enhanced harmonic sonography, contrast-enhanced power Doppler sonography, and helical CT. , 2001, AJR. American journal of roentgenology.

[25]  D. Choi,et al.  Hepatocellular carcinoma treated with percutaneous radio-frequency ablation: evaluation with follow-up multiphase helical CT. , 2001, Radiology.

[26]  L Solbiati,et al.  Essential techniques for successful radio-frequency thermal ablation of malignant hepatic tumors. , 2001, Radiographics : a review publication of the Radiological Society of North America, Inc.

[27]  K. Shirato,et al.  Percutaneous ablation therapy guided by contrast-enhanced sonography for patients with hepatocellular carcinoma. , 2003, AJR. American journal of roentgenology.

[28]  Luigi Solbiati,et al.  Radiofrequency thermal ablation of hepatic metastases. , 2001, European journal of ultrasound : official journal of the European Federation of Societies for Ultrasound in Medicine and Biology.

[29]  L Solbiati,et al.  Small hepatocellular carcinoma: treatment with radio-frequency ablation versus ethanol injection. , 1999, Radiology.

[30]  S. Curley,et al.  Radio-frequency ablation of liver tumors: assessment of therapeutic response and complications. , 2001, Radiographics : a review publication of the Radiological Society of North America, Inc.

[31]  P R Mueller,et al.  Treatment of intrahepatic malignancy with radiofrequency ablation , 2000, Cancer.

[32]  O. Catalano,et al.  Hepatocellular carcinoma recurrence after percutaneous ablation therapy: helical CT patterns , 2001, Abdominal Imaging.

[33]  S. Nahum Goldberg,et al.  The role of contrast-enhanced ultrasound in the detection of focal liver leasions , 2001, European Radiology.

[34]  G. Manenti,et al.  Laser thermal ablation in the treatment of small hepatocellular carcinoma: results in 74 patients. , 2001, Radiology.

[35]  R Fiocca,et al.  Percutaneous US-guided radio-frequency tissue ablation of liver metastases: treatment and follow-up in 16 patients. , 1997, Radiology.

[36]  H. Sekihara,et al.  Using contrast-enhanced sonography to assess the effectiveness of transcatheter arterial embolization for hepatocellular carcinoma. , 2001, AJR. American journal of roentgenology.

[37]  H K Lim,et al.  Hepatocellular carcinoma treated with percutaneous radio-frequency ablation: usefulness of power Doppler US with a microbubble contrast agent in evaluating therapeutic response-preliminary results. , 2000, Radiology.