Evaluation of the therapeutic efficacy of high-intensity focused ultrasound ablation of hepatocellular carcinoma by three-dimensional sonography with a perflubutane-based contrast agent
Evaluation of the therapeutic efficacy of high-intensity focused ultrasound ablation of hepatocellular carcinoma by three-dimensional sonography with a perflubutane-based contrast agent
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DOI：
10.1016/j.ejrad.2009.11.022
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发表时间：
2010-08-01
影响因子：
3.3
通讯作者：
Tanaka, Katsuaki
中科院分区：
文献类型：
--
作者：
Numata, Kazushi;Fukuda, Hiroyuki;Tanaka, Katsuaki
目的：我们进行了对比增强三维超声检查（CE 3D US）与基于全氟丁烷的造影剂，以立即评价通过体外高强度聚焦超声（HIFU）消融小肝细胞癌（HCC）病变的完整性。21个HCC病灶通过单次超声引导的HIFU消融治疗，并在消融前、消融后即刻、消融后即刻结果：17个病灶在HIFU治疗后即刻和1个月时，经CE 3D超声评估为充分消融，4个病灶为残余肿瘤，其余病灶均在HIFU治疗前、治疗后1周和1个月时进行增强CT（CE CT）或增强MRI（CE MRI）检查。HIFU治疗后1个月，18例经CE CT或CE MRI评估为充分消融，另3例为残留肿瘤。HIFU治疗后即刻CE 3D US和HIFU治疗后1个月CE CT或CE MRI的评价与20处病变一致。两名设盲观察者的CE 3D US和其他模式的结果之间一致性的kappa值为0.83。以1个月的CE CT或CE MRI结果为参考标准，HIFU治疗后即刻CE 3D US诊断充分消融的敏感性为100%，特异性为75%，准确性为95%，CE 3D US是一种可用于HIFU治疗后即刻评价疗效的有效方法。(C)2009爱思唯尔爱尔兰有限公司保留所有权利。
Objective: We performed contrast-enhanced three-dimensional sonography (CE 3D US) with a perflubutane-based contrast agent to immediately evaluate the completeness of ablation of small hepatocellular carcinoma (HCC) lesions by extracorporeal high-intensity focused ultrasound (HIFU).Subjects and methods: Twenty-one HCC lesions were treated by a single ultrasound-guided HIFU ablation session, and CE 3D US was performed before, immediately after, and 1 week, and 1 month after HIFU, and contrast-enhanced CT (CE CT) or contrast-enhanced MRI (CE MRI) was performed before HIFU, 1 week and 1 month after HIFU, and during the follow-up period.Results: Immediately and 1 month after HIFU, 17 lesions were evaluated as adequately ablated by CE 3D US, and the other 4 lesions as residual tumors. One month after HIFU, 18 were evaluated as adequately ablated by CE CT or CE MRI, and the other 3 as residual tumors. The evaluation by CE 3D US immediately after HIFU and by CE CT or CE MRI 1 month after HIFU was concordant with 20 lesions. The kappa value for agreement between the findings of CE 3D US and other modalities by two blinded observers was 0.83. When the 1-month CE CT or CE MRI findings were used as the reference standard, the sensitivity, specificity, and accuracy of CE 3D US immediately after HIFU for the diagnosis of the adequate ablation were 100%, 75%, and 95%, respectively.Conclusion: CE 3D US appears to be a useful method for immediate evaluation of therapeutic efficacy of HIFU ablation of HCC lesions. (C) 2009 Elsevier Ireland Ltd. All rights reserved.