Multimodality imaging to assess immediate response following irreversible electroporation in patients with malignant hepatic tumors
Multimodality imaging to assess immediate response following irreversible electroporation in patients with malignant hepatic tumors
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DOI：
10.1007/s10396-016-0767-0
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发表时间：
2017-07-01
影响因子：
1.8
通讯作者：
Itoi, Takao
中科院分区：
文献类型：
--
作者：
Sugimoto, Katsutoshi;Moriyasu, Fuminori;Itoi, Takao
目的评价超声造影(CEUS)、多期CT增强扫描(CECT)和增强磁共振成像(EOB-MRI)对不可逆电穿孔(IRE)治疗的16例21个肝脏病变的诊断价值。每隔3个月行EOB-MRI或CECT及CEUS随访检查。两位放射科医生独立审查了这些图像，并使用带有受试者工作特征(ROC)曲线分析的五点量表评估了肿瘤残留的可能性。并对其敏感性和特异性进行了评价。结果CEUS的ROC曲线下面积(0.980)显著高于CECT(0.742，P<0.01)和EOB-MRI(0.806，P<0.01)。CEUS的敏感性和特异性分别为85.7%和85.7%，CECT分别为64.3%和46.4%，EOB-MRI分别为78.6%和64.3%。结论CEUS诊断IRE术后亚急性期肿瘤残留优于CECT和EOB-MRI。
Purpose To assess the diagnostic accuracy of contrastenhanced ultrasound (CEUS), contrast-enhanced multiphase CT (CECT), and gadoxetic acid-enhanced MRI (EOB-MRI) in identifying residual tumor in the subacute follow-up of patients with malignant hepatic tumors treated by irreversible electroporation (IRE).Methods We enrolled 16 patients with 21 hepatic lesions treated by IRE and examined by CEUS and CECT at 1 day after IRE and by EOB-MRI at 7 days after IRE. Follow-up examinations by EOB-MRI or CECT and CEUS were performed at 3-month intervals. Two radiologists independently reviewed the images and assessed the probability of residual tumor using a five-point scale with receiver operating characteristic (ROC) curve analysis. The sensitivity and specificity were also evaluated. Verifiable local recurrence was assessed using follow-up imaging as the reference standard.Results The mean area under the ROC curve was significantly higher for CEUS (0.980) than for CECT (0.742, P < 0.01) and EOB-MRI (0.806, P < 0.01), as were the sensitivity and specificity (mean 85.7 and 85.7% for CEUS, respectively, vs 64.3 and 46.4% for CECT and 78.6 and 64.3% for EOB-MRI).Conclusion CEUS was found to be superior to CECT and EOB-MRI for the diagnosis of residual tumor in the subacute phase following IRE.