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Cancer Imaging

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Open Access 01-12-2024 | Hepatocellular Carcinoma | Research article

Contrast-enhanced ultrasonography–CT/MRI fusion guidance for percutaneous ablation of inconspicuous, small liver tumors: improving feasibility and therapeutic outcome

Authors: Yuna Lee, Jeong Hee Yoon, Seungchul Han, Ijin Joo, Jeong Min Lee

Published in: Cancer Imaging | Issue 1/2024

Abstract

Background

Percutaneous radiofrequency ablation (RFA) is pivotal for treating small malignant liver tumors, but tumors often remain inconspicuous on B-mode ultrasound (US). This study evaluates the potential of CEUS-CT/MRI fusion imaging (FI) to improve tumor visibility and the associated RFA outcomes for small (≤ 3 cm) malignant liver tumors that were inconspicuous on US.

Methods

Between January 2019 and April 2021, a prospective study enrolled 248 patients with liver malignancies (≤ 3 cm) that were poorly visible on B-mode US. Tumor visibility and ablation feasibility were assessed using B-mode US, US-CT/MRI FI, and CEUS-CT/MRI FI, and graded on a 4-point scale. CEUS was employed post-registration of US and CT/MRI images, utilizing either SonoVue or Sonazoid. Comparisons between US-based and CEUS-based fusion visibility and feasibility scores were undertaken using the Friedman test. Moreover, rates of technical success, technique efficacy, local tumor progression (LTP), and major complications were assessed.

Results

The cohort included 223 hepatocellular carcinomas (HCCs) (89.9%) and 23 metastases (9.3%), with an average tumor size of 1.6 cm. CEUS-CT/MRI FI demonstrated a significant advantage in tumor visibility (3.4 ± 0.7 vs. 1.9 ± 0.6, P < 0.001) and technical feasibility (3.6 ± 0.6 vs. 2.9 ± 0.8, P < 0.001) compared to US-FI. In 85.5% of patients, CEUS addition to US-FI ameliorated tumor visibility. Technical success was achieved in 99.6% of cases. No severe complications were reported. One and two-year post CEUS-CT/MRI FI-guided RFA estimates for LTP were 9.3% and 10.9%, respectively.

Conclusions

CEUS-CT/MRI FI significantly improves the visualization of tumors not discernible on B-mode US, thus augmenting percutaneous RFA success and delivering improved therapeutic outcomes.

Trial registration

ClinicalTrials.gov, NCT05445973. Registered 17 June 2022 – Retrospectively registered, http://clinicaltrials.gov/study/NCT05445973?id=NCT05445973&rank=1.

Available only for authorised users

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Title: Contrast-enhanced ultrasonography–CT/MRI fusion guidance for percutaneous ablation of inconspicuous, small liver tumors: improving feasibility and therapeutic outcome
Authors: Yuna Lee
Jeong Hee Yoon
Seungchul Han
Ijin Joo
Jeong Min Lee
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Hepatocellular Carcinoma
Hepatocellular Carcinoma
Published in: Cancer Imaging / Issue 1/2024
Electronic ISSN: 1470-7330
DOI: https://doi.org/10.1186/s40644-023-00650-y

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Background

Methods

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