1
|
Hu H, Zhao Y, He C, Qian L, Huang P. Ultrasonography of Hepatocellular Carcinoma: From Diagnosis to Prognosis. J Clin Transl Hepatol 2024; 12:516-524. [PMID: 38779517 PMCID: PMC11106354 DOI: 10.14218/jcth.2024.00018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 03/15/2024] [Accepted: 04/07/2024] [Indexed: 05/25/2024] Open
Abstract
Hepatocellular carcinoma (HCC) is a prominent contributor to cancer-related mortality worldwide. Early detection and diagnosis of liver cancer can significantly improve its prognosis and patient survival. Ultrasound technology, serving has undergone substantial advances as the primary method of HCC surveillance and has broadened its scope in recent years for effective management of HCC. This article is a comprehensive overview of ultrasound technology in the treatment of HCC, encompassing early detection, diagnosis, staging, treatment evaluation, and prognostic assessment. In addition, the authors summarized the application of contrast-enhanced ultrasound in the diagnosis of HCC and assessment of prognosis. Finally, the authors discussed further directions in this field by emphasizing overcoming existing obstacles and integrating cutting-edge technologies.
Collapse
Affiliation(s)
- Huisen Hu
- Department of Ultrasound, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Department of Ultrasound, Lanxi People’s Hospital, Lanxi, Zhejiang, China
| | - Yonglei Zhao
- Department of Radiology, Sir Run Run Shaw Hospital (SRRSH), Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Chengbin He
- Department of Radiology, Sir Run Run Shaw Hospital (SRRSH), Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Lujie Qian
- The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Pintong Huang
- Department of Ultrasound, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| |
Collapse
|
2
|
Wu S, Zheng Y, Wang L, Liu W. Differences in influencing mechanism of clinicians' adoption behavior for liver cancer screening technology between the leading and subordinate hospitals within medical consortiums. BMC Cancer 2024; 24:514. [PMID: 38654313 DOI: 10.1186/s12885-024-12281-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 04/17/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Medical consortiums have been extensively established to facilitate the integration of health resources and bridge the technical gap among member institutions. However, some commonly appropriate technologies remain stagnant in subordinate hospitals, although they have been routinely applied in leading hospitals. Besides, the mechanism underlying differences in clinicians' adoption behavior at different levels of institutions was unknown. Therefore, this study aimed to investigate the differences in influencing mechanisms of clinicians' hepatic contrast-enhanced ultrasound technology (CEUS) utilization behavior between leading and subordinate hospitals within medical consortiums, thus providing clues for expanding effective and appropriate technologies within integrated care systems. METHODS A self-designed scale was developed based on the theory of planned behavior (TPB). A multistage sampling method was applied to investigate clinicians who were aware of CEUS and worked in liver disease-related departments within the sampled medical institutions. The final sample size was 289. AMOS 24.0 software was used to construct multi-group structural equation modeling (SEM) to validate the hypotheses and determine the mechanism of hepatic CEUS utilization. RESULTS It revealed that behavioral intention significantly influenced adoption behavior, regardless of whether it was in leading hospitals or subordinate hospitals (β = 0.283, p < 0.001). Furthermore, behavioral attitude (β = 0.361, p < 0.001) and perceived behavioral control (β = 0.582, p < 0.001) exerted significant effects on adoption behavior through behavioral intention. However, in leading hospitals, subjective norm had a significant positive effect on behavioral intention (β = 0.183, p < 0.01), while it had a significant negative impact on behavioral intention in the subordinate hospitals (β = -0.348, p < 0.01). CONCLUSION To effectively translate the adoption intention into actual behavior, it is recommended to elucidate the demand and facilitators involved in the process of health technology adoption across leading and subordinate hospitals. Additionally, bolstering technical support and knowledge dissemination within subordinate hospitals while harnessing the influential role of key individuals can further enhance this transformative process.
Collapse
Affiliation(s)
- Shiyin Wu
- Department of Social Medicine and Health Management, School of Health Management, Fujian Medical University, 1 Xuefubei Road, Minhou District, 350122, Fuzhou, China
| | - Yuhang Zheng
- Department of Social Medicine and Health Management, School of Health Management, Fujian Medical University, 1 Xuefubei Road, Minhou District, 350122, Fuzhou, China
| | - Lingjie Wang
- Department of Social Medicine and Health Management, School of Health Management, Fujian Medical University, 1 Xuefubei Road, Minhou District, 350122, Fuzhou, China
| | - Wenbin Liu
- Department of Social Medicine and Health Management, School of Health Management, Fujian Medical University, 1 Xuefubei Road, Minhou District, 350122, Fuzhou, China.
| |
Collapse
|
3
|
Hu Q, Zeng Z, Zhang Y, Fan X. Study of ultrasound-guided percutaneous microwave ablation combined with portal vein embolization for rapid future liver remnant increase of planned hepatectomy. Front Oncol 2023; 12:926810. [PMID: 36686725 PMCID: PMC9846746 DOI: 10.3389/fonc.2022.926810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 12/07/2022] [Indexed: 01/05/2023] Open
Abstract
Purpose To evaluate the efficacy of ultrasound-guided percutaneous microwave ablation (PMA) combined with portal vein embolization (PVE) for planned hepatectomy. Methods We retrospectively reviewed data of 18 patients with multiple right liver tumors or hilar tumor of liver invades the surrounding tissue and insufficient future liver remnant (FLR) for hepatectomy from July 2015 to March 2017. Ultrasound-guided PMA was performed by using PMCT cold circulation microwave treatment apparatus. PVE was performed after PMA. The increase of FLR was evaluated by computed tomography (CT) 6-22 days after PVE. The proportion of FLR, increase in the amplitude of FLR, procedure-related complications, perioperative morbidity and mortality, and overall survival (OS) rates, the median survival time were analyzed. Results The median volume of FLR before PMA and PVE was 369.7 ml (range: 239.4-493.1 ml). After a median waiting period of 11.5 days (range: 6-22 days), the median volume of FLR was increased to 523.4 ml (range: 355.4-833.3 ml). The changes in FLR before and after PMA and PVE were statistically significant (p<0.001). No serious perioperative complications or mortality were found. After a median follow-up time of 51.0 months (range: 2-54 months), the 6-month, 1-year, 2-year, 3-year and 4-year survival rates were 88.9%, 72.2%, 44.4%, 33.3%, 22.2%, respectively, and the median survival time was 15.0 ± 7.1 months. Conclusion PMA combined with PVE increases FLR rapidly, avoids touching malignant tumors, and produces fewer procedure-related complications. It appears safe and efficacious for planned hepatectomy.
Collapse
Affiliation(s)
- Qiaohong Hu
- Cancer Center, Department of Ultrasound Medicine, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Zeng Zeng
- Cancer Center, Department of Ultrasound Medicine, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Yuanbiao Zhang
- Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xiaoming Fan
- Cancer Center, Department of Ultrasound Medicine, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China,*Correspondence: Xiaoming Fan,
| |
Collapse
|
4
|
Zhang Y, Numata K, Du Y, Maeda S. Contrast Agents for Hepatocellular Carcinoma Imaging: Value and Progression. Front Oncol 2022; 12:921667. [PMID: 35720001 PMCID: PMC9200965 DOI: 10.3389/fonc.2022.921667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 05/02/2022] [Indexed: 11/25/2022] Open
Abstract
Hepatocellular carcinoma (HCC) has the third-highest incidence in cancers and has become one of the leading threats to cancer death. With the research on the etiological reasons for cirrhosis and HCC, early diagnosis has been placed great hope to form a favorable prognosis. Non-invasive medical imaging, including the associated contrast media (CM)-based enhancement scan, is taking charge of early diagnosis as mainstream. Meanwhile, it is notable that various CM with different advantages are playing an important role in the different imaging modalities, or even combined modalities. For both physicians and radiologists, it is necessary to know more about the proper imaging approach, along with the characteristic CM, for HCC diagnosis and treatment. Therefore, a summarized navigating map of CM commonly used in the clinic, along with ongoing work of agent research and potential seeded agents in the future, could be a needed practicable aid for HCC diagnosis and prognosis.
Collapse
Affiliation(s)
- Ying Zhang
- Department of Medical Ultrasound, Ningbo Medical Centre Li Huili Hospital, Ningbo, China.,Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan.,Department of Gastroenterology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Kazushi Numata
- Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Yuewu Du
- Department of Medical Ultrasound, Ningbo Medical Centre Li Huili Hospital, Ningbo, China
| | - Shin Maeda
- Department of Gastroenterology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| |
Collapse
|
5
|
Inzerillo A, Meloni MF, Taibbi A, Bartolotta TV. Loco-regional treatment of hepatocellular carcinoma: Role of contrast-enhanced ultrasonography. World J Hepatol 2022; 14:911-922. [PMID: 35721286 PMCID: PMC9157715 DOI: 10.4254/wjh.v14.i5.911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/26/2021] [Accepted: 04/21/2022] [Indexed: 02/06/2023] Open
Abstract
Hepatocellular carcinoma (HCC) is one of the few cancers for which locoregional treatments (LRTs) are included in international guidelines and are considered as a valid alternative to conventional surgery. According to Barcelona Clinic Liver Cancer classification, percutaneous treatments such as percutaneous ethanol injection, radiofrequency ablation and microwave ablation are the therapy of choice among curative treatments in patients categorized as very early and early stage, while transcatheter arterial chemoembolization is considered the better option for intermediate stage HCC. A precise assessment of treatment efficacy and surveillance is essential to optimize survival rate, whereas residual tumor requires additional treatment. Imaging modalities play a key role in this task. Currently, contrast-enhanced computed tomography/magnetic resonance imaging are considered the standard imaging modalities for this purpose. Contrast enhanced ultrasound (CEUS), using second generation contrast agents, plays an increasingly important role in detecting residual disease after LRTs. CEUS is a straightforward to perform, repeatable and cost-effective imaging modality for patients with renal failure or iodine allergies. Due to the ability to focus on single regions, CEUS can also provide high temporal resolution. Moreover, several studies have reported the same or better diagnostic accuracy as contrast-enhanced computed tomography for assessing tumor vascularity 1 mo after LRTs, and recently three-dimensional (3D)-CEUS has been reported as a promising technique to improve the evaluation of tumor response to therapy. Furthermore, CEUS could be used early after procedures in monitoring HCC treatments, but nowadays this indication is still debated, and data from literature are conflicting, especially after transcatheter arterial chemoembolization procedure.
Collapse
Affiliation(s)
- Agostino Inzerillo
- Department of Radiology, University Hospital "Paolo Giaccone", Palermo 90127, Italy
| | | | - Adele Taibbi
- Department of Radiology, University Hospital "Paolo Giaccone", Palermo 90127, Italy
| | - Tommaso Vincenzo Bartolotta
- Department of Radiology, University Hospital "Paolo Giaccone", Palermo 90127, Italy
- Department of Radiology, Fondazione Istituto G. Giglio Hospital, Cefalù 90015, Italy
| |
Collapse
|
6
|
Bartolotta TV, Randazzo A, Bruno E, Taibbi A. Focal liver lesions in cirrhosis: Role of contrast-enhanced ultrasonography. World J Radiol 2022; 14:70-81. [PMID: 35646291 PMCID: PMC9124982 DOI: 10.4329/wjr.v14.i4.70] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/16/2021] [Accepted: 04/09/2022] [Indexed: 02/06/2023] Open
Abstract
Contrast-enhanced ultrasound (CEUS) represents a great innovation for the evaluation of focal liver lesions (FLLs). The main advantage of CEUS is the real-time imaging examination and the very low toxicity in patients with renal failure. Liver cirrhosis has been recognized as a major risk factor for the onset of hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC). HCC in liver cirrhosis develops as the last step of a complex that leads to the gradual transformation from regenerative nodule through dysplastic nodule to HCC. In patients with liver cirrhosis, a surveillance program is recommended consisting of ultrasound (US) for detecting small focal lesions. A wide spectrum of benign and malignant lesions other than HCC may be found in the cirrhotic liver and their differentiation is important to avoid errors in staging diseases that may preclude potentially curative therapies. Several published studies have explored the value of CEUS in liver cirrhosis and they have been shown to have excellent diagnostic and prognostic performances for the evaluation of non-invasive and efficient diagnosis of FLLs in patients at high risk for liver malignancies. The purpose of this article is to describe and discuss CEUS imaging findings of FLLs including HCC and ICC, all of which occur in cirrhotic livers with varying prevalence.
Collapse
Affiliation(s)
- Tommaso Vincenzo Bartolotta
- Department of Radiology, University Hospital "Paolo Giaccone", Palermo 90127, Italy
- Department of Radiology, Fondazione Istituto G. Giglio Hospital, Cefalù 90015, Italy
| | - Angelo Randazzo
- Department of Radiology, University Hospital "Paolo Giaccone", Palermo 90127, Italy
| | - Eleonora Bruno
- Department of Radiology, University Hospital "Paolo Giaccone", Palermo 90127, Italy
| | - Adele Taibbi
- Department of Radiology, University Hospital "Paolo Giaccone", Palermo 90127, Italy
| |
Collapse
|
7
|
Geoghegan R, Ter Haar G, Nightingale K, Marks L, Natarajan S. Methods of monitoring thermal ablation of soft tissue tumors - A comprehensive review. Med Phys 2022; 49:769-791. [PMID: 34965307 DOI: 10.1002/mp.15439] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 11/30/2020] [Accepted: 12/15/2021] [Indexed: 11/12/2022] Open
Abstract
Thermal ablation is a form of hyperthermia in which oncologic control can be achieved by briefly inducing elevated temperatures, typically in the range 50-80°C, within a target tissue. Ablation modalities include high intensity focused ultrasound, radiofrequency ablation, microwave ablation, and laser interstitial thermal therapy which are all capable of generating confined zones of tissue destruction, resulting in fewer complications than conventional cancer therapies. Oncologic control is contingent upon achieving predefined coagulation zones; therefore, intraoperative assessment of treatment progress is highly desirable. Consequently, there is a growing interest in the development of ablation monitoring modalities. The first section of this review presents the mechanism of action and common applications of the primary ablation modalities. The following section outlines the state-of-the-art in thermal dosimetry which includes interstitial thermal probes and radiologic imaging. Both the physical mechanism of measurement and clinical or pre-clinical performance are discussed for each ablation modality. Thermal dosimetry must be coupled with a thermal damage model as outlined in Section 4. These models estimate cell death based on temperature-time history and are inherently tissue specific. In the absence of a reliable thermal model, the utility of thermal monitoring is greatly reduced. The final section of this review paper covers technologies that have been developed to directly assess tissue conditions. These approaches include visualization of non-perfused tissue with contrast-enhanced imaging, assessment of tissue mechanical properties using ultrasound and magnetic resonance elastography, and finally interrogation of tissue optical properties with interstitial probes. In summary, monitoring thermal ablation is critical for consistent clinical success and many promising technologies are under development but an optimal solution has yet to achieve widespread adoption.
Collapse
Affiliation(s)
- Rory Geoghegan
- Department of Urology, University of California Los Angeles, Los Angeles, California, USA
| | - Gail Ter Haar
- Department of Physics, Institute of Cancer Research, University of London, Sutton, UK
| | - Kathryn Nightingale
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA
| | - Leonard Marks
- Department of Urology, University of California Los Angeles, Los Angeles, California, USA
| | - Shyam Natarajan
- Departments of Urology & Bioengineering, University of California Los Angeles, Los Angeles, California, USA
| |
Collapse
|
8
|
Image-guided Percutaneous Biopsy of the Liver. Tech Vasc Interv Radiol 2021; 24:100773. [PMID: 34895710 DOI: 10.1016/j.tvir.2021.100773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Percutaneous Biopsy of the Liver (PBL) is a cornerstone in the diagnosis of parenchymal liver disease and focal hepatic lesions. The indications for PBL can broadly be divided into those used to garner information regarding diagnosis, prognosis, or treatment. While the diagnosis of many common liver diseases can usually be made with imaging and serologic testing alone, PBL may be indicated in situations where the diagnosis is in question. Furthermore, liver biopsies are a foundational element for personalized treatment approaches for cancer patients; increasing emphasis is being placed on acquiring sufficient tissue for molecular profiling. While a variety of image guidance and procedural techniques have been applied to PBL, following conventional principles can ensure technical success and minimize complication risks. In this technique article, we review the practical periprocedural considerations of PBL with emphasis on recent advancements and societal recommendations.
Collapse
|
9
|
Zhang W, Zhang W, Guo Q, Chen L, Meng Z, Xu Y, Cao N, Hu B, Qian B. The Design and Rationale of a Multicentre Randomised Controlled Trial Comparing Transperineal Percutaneous Laser Ablation With Transurethral Resection of the Prostate for Treating Benign Prostatic Hyperplasia. Front Surg 2021; 8:755957. [PMID: 34733883 PMCID: PMC8558367 DOI: 10.3389/fsurg.2021.755957] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 09/22/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Transurethral resection of the prostate (TURP) is regarded as the “gold standard” for the treatment of benign prostatic hyperplasia (BPH) in elderly men. However, ~15% of patients who had undergone TURP had intraoperative and postoperative complications, such as bleeding, urinary incontinence and urethral stricture. Transperineal percutaneous laser ablation (TPLA) is a method that places the optical fibre directly into the prostate with the guidance of ultrasound imaging, and the percutaneous transperineal approach is performed distal to the urethra and rectum to protect these structures and reduce urethral or postoperative infection. Several studies on TPLA for BPH treatment have been reported recently; however, high-quality randomised controlled trial (RCT) to evaluate its efficacy, safety, and long-term follow up remain absent. Methods: This study is a multicentre, open-label RCT to assess the efficacy and safety of TPLA vs. TURP to treat BPH. We hypothesise that the TPLA has non-inferior efficacy to TURP in the International Prostate Symptom Score (IPSS) at 3 months changing from the baseline and lower incidence of post-surgery complications. One hundred and fourteen patients with BPH will be recruited at 19 sites and randomly assigned at 1:1 to TPLA or TURP groups. The patients will be followed up at 1, 3, 6, 12, and 24 months after the procedure. Discussion: The study will be the first multicentre clinical trial including 16 participating centres in China, Italy, Switzerland, and Poland with relatively large sample size 114. By comprehensively compare the safety and efficacy of TPLA with TURP in patients with BPH, especially concerning the improvement of lower urinary tract symptoms (LUTS) and complication incidence, the study will help to illustrate the clinical value of TPLA and provide a beneficial alternative treatment for BPH patients. Clinical Trial Registration: The study has been registered on Chinese Clinical Trial Registry (http://www.chictr.org.cn), identifier [ChiCTR1900022739].
Collapse
Affiliation(s)
- Wei Zhang
- Department of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated 6th People's Hospital, Shanghai, China.,Shanghai Institute of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated 6th People's Hospital, Shanghai, China
| | - Weituo Zhang
- Clinical Research Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qian Guo
- Department of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated 6th People's Hospital, Shanghai, China.,Shanghai Institute of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated 6th People's Hospital, Shanghai, China
| | - Lei Chen
- Department of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated 6th People's Hospital, Shanghai, China.,Shanghai Institute of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated 6th People's Hospital, Shanghai, China
| | - Zheying Meng
- Department of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated 6th People's Hospital, Shanghai, China.,Shanghai Institute of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated 6th People's Hospital, Shanghai, China
| | - Yanjun Xu
- Department of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated 6th People's Hospital, Shanghai, China.,Shanghai Institute of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated 6th People's Hospital, Shanghai, China
| | - Nailong Cao
- Department of Urology, Shanghai Jiao Tong University Affiliated 6th People's Hospital, Shanghai, China
| | - Bing Hu
- Department of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated 6th People's Hospital, Shanghai, China.,Shanghai Institute of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated 6th People's Hospital, Shanghai, China
| | - Biyun Qian
- Hongqiao International Institute of Medicine, Shanghai Tong Ren Hospital, Shanghai, China
| |
Collapse
|
10
|
Nielsen MB, Søgaard SB, Bech Andersen S, Skjoldbye B, Hansen KL, Rafaelsen S, Nørgaard N, Carlsen JF. Highlights of the development in ultrasound during the last 70 years: A historical review. Acta Radiol 2021; 62:1499-1514. [PMID: 34791887 DOI: 10.1177/02841851211050859] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This review looks at highlights of the development in ultrasound, ranging from interventional ultrasound and Doppler to the newest techniques like contrast-enhanced ultrasound and elastography, and gives reference to some of the valuable articles in Acta Radiologica. Ultrasound equipment is now available in any size and for any purpose, ranging from handheld devices to high-end devices, and the scientific societies include ultrasound professionals of all disciplines publishing guidelines and recommendations. Interventional ultrasound is expanding the field of use of ultrasound-guided interventions into nearly all specialties of medicine, from ultrasound guidance in minimally invasive robotic procedures to simple ultrasound-guided punctures performed by general practitioners. Each medical specialty is urged to define minimum requirements for equipment, education, training, and maintenance of skills, also for medical students. The clinical application of contrast-enhanced ultrasound and elastography is a topic often seen in current research settings.
Collapse
Affiliation(s)
- Michael Bachmann Nielsen
- Department of Radiology, Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Stinne Byrholdt Søgaard
- Department of Radiology, Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Sofie Bech Andersen
- Department of Radiology, Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Bjørn Skjoldbye
- Department of Radiology, Aleris-Hamlet Hospitals, Copenhagen Denmark
| | - Kristoffer Lindskov Hansen
- Department of Radiology, Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Søren Rafaelsen
- Department of Radiology, University Hospital of Southern Denmark, Vejle, Denmark
- Faculty of Health Sciences, Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Nis Nørgaard
- Department of Urology, Herlev Gentofte Hospital, Copenhagen, Denmark
| | - Jonathan F. Carlsen
- Department of Radiology, Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
11
|
Bartolotta TV, Taibbi A, Randazzo A, Gagliardo C. New frontiers in liver ultrasound: From mono to multi parametricity. World J Gastrointest Oncol 2021; 13:1302-1316. [PMID: 34721768 PMCID: PMC8529919 DOI: 10.4251/wjgo.v13.i10.1302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 07/17/2021] [Accepted: 08/24/2021] [Indexed: 02/06/2023] Open
Abstract
Modern liver ultrasonography (US) has become a “one-stop shop” able to provide not only anatomic and morphologic but also functional information about vascularity, stiffness and other various liver tissue properties. Modern US techniques allow a quantitative assessment of various liver diseases. US scanning is no more limited to the visualized plane, but three-dimensional, volumetric acquisition and consequent post-processing are also possible. Further, US scan can be consistently merged and visualized in real time with Computed Tomography and Magnetic Resonance Imaging examinations. Effective and safe microbubble-based contrast agents allow a real time, dynamic study of contrast kinetic for the detection and characterization of focal liver lesions. Ultrasound can be used to guide loco-regional treatment of liver malignancies and to assess tumoral response either to interventional procedures or medical therapies. Microbubbles may also carry and deliver drugs under ultrasound exposure. US plays a crucial role in diagnosing, treating and monitoring focal and diffuse liver disease. On the basis of personal experience and literature data, this paper is aimed to review the main topics involving recent advances in the field of liver ultrasound.
Collapse
Affiliation(s)
- Tommaso Vincenzo Bartolotta
- Department of Radiology, University Hospital "Paolo Giaccone", Palermo 90127, Italy
- Radiology Department, Fondazione Istituto G. Giglio Hospital, Cefalù 90015, Italy
| | - Adele Taibbi
- Department of Radiology, University Hospital "Paolo Giaccone", Palermo 90127, Italy
| | - Angelo Randazzo
- Department of Radiology, University Hospital "Paolo Giaccone", Palermo 90127, Italy
| | - Cesare Gagliardo
- Department of Biopathology and Medical and Forensic Biotechnologies, University of Palermo, Palermo 90127, Italy
| |
Collapse
|
12
|
Minami Y, Morita M, Chishina H, Aoki T, Takita M, Hagiwara S, Ida H, Ueshima K, Nishida N, Kudo M. Can the Entire Ablative Hyperechoic Zone be Regarded as a Necrotic Lesion After Radiofrequency Ablation of the Liver? ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:2930-2935. [PMID: 34266681 DOI: 10.1016/j.ultrasmedbio.2021.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 05/04/2021] [Accepted: 05/06/2021] [Indexed: 06/13/2023]
Abstract
Developments in image fusion technology made it possible to visualize the ablative margin on ultrasound (US). The purpose of the present study was to assess the ablative area of radiofrequency ablation for hepatocellular carcinoma and compare it with the ablative hyperechoic zone with a non-enhanced area on contrast-enhanced US/contrast-enhanced computed tomography (CEUS/CECT) in the same cross-section. This retrospective study included 25 patients with 27 hepatocellular carcinomas. The long and short dimensions of the ablative hyperechoic zone were measured using B-mode US, and those of the non-enhanced area were assessed with CEUS/CECT on the same cross-section measured with B-mode US, using image fusion techniques. The technical effectiveness of ablation with an adequate ablative margin in a single session was determined in all patients. The long and short dimensions of the ablative hyperechoic zone ranged between 15.0 and 40.7 mm (mean: 27.3 ± 6.9 mm) and between 14.0 and 33.0 mm (mean: 23.3 ± 5.8 mm), respectively. R values for the long and short dimensions were 0.99 and 0.98, respectively, between B-mode US and CEUS, and 0.96 and 0.92, respectively, between B-mode US and CECT. The ablative hyperechoic zone may be regarded as a necrotic lesion after radiofrequency ablation.
Collapse
Affiliation(s)
- Yasunori Minami
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan.
| | - Masahiro Morita
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Hirokazu Chishina
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Tomoko Aoki
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Masahiro Takita
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Satoru Hagiwara
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Hiroshi Ida
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Kazuomi Ueshima
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Naoshi Nishida
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Masatoshi Kudo
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan
| |
Collapse
|
13
|
Francica G, Meloni MF, Riccardi L, Giangregorio F, Caturelli E, Terracciano F, de Sio I. Role of Contrast-Enhanced Ultrasound in the Detection of Complications After Ultrasound-Guided Liver Interventional Procedures. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2021; 40:1665-1673. [PMID: 33085814 DOI: 10.1002/jum.15540] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/26/2020] [Accepted: 09/29/2020] [Indexed: 06/11/2023]
Abstract
The role of contrast-enhanced ultrasound (CEUS) in interventional ultrasound-guided procedures in the liver has been increasingly recognized. However, little is known about the capability of CEUS for diagnosing complications after liver biopsy and ablation with special regard to postprocedural hemorrhage. The aim of this Pictorial Essay is to present the CEUS features of a wide spectrum of vascular complications (with or without bleeding) and injuries of the surrounding abdominal and chest wall occurring after liver interventional procedures.
Collapse
Affiliation(s)
- Giampiero Francica
- Unità di Ecografia Interventistica, Pineta Grande Hospital, Castel Volturno, Italy
| | - Maria Franca Meloni
- Servizio di Radiologia, Casa di Cura Igea, Milan, Italy
- Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA
| | - Laura Riccardi
- Medicina e Interna e Gastroenterologia, Università Cattolica del Sacro Cuore Facoltà di Medicina e Chirurgia, Rome, Italy
| | | | | | - Fulvia Terracciano
- Gastroenterologia, Istituto di Ricovero e Cura a Carattere Scientifico, Ospedale Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Italy
| | - Ilario de Sio
- Epatogastroenterologia, Università Degli Studi Della Campania Luigi Vanvitelli, Naples, Italy
| |
Collapse
|
14
|
Eisenbrey JR, Gabriel H, Savsani E, Lyshchik A. Contrast-enhanced ultrasound (CEUS) in HCC diagnosis and assessment of tumor response to locoregional therapies. Abdom Radiol (NY) 2021; 46:3579-3595. [PMID: 33825927 DOI: 10.1007/s00261-021-03059-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/05/2021] [Accepted: 03/09/2021] [Indexed: 02/06/2023]
Abstract
Hepatocellular carcinoma (HCC) is a global problem constituting the second leading cause of cancer deaths worldwide, thereby necessitating an accurate and cost-effective solution for managing care. Ultrasound is well poised to address this need due to its low cost, portability, safety, and excellent temporal resolution. The role of ultrasound for HCC screening has been well established and supported by multiple international guidelines. Similarly, contrast-enhanced ultrasound (CEUS) can be used for the characterization of focal liver lesions in high-risk populations, and standardized criteria for CEUS have been established by the American College of Radiology Liver Imaging Reporting & Data System (LI-RADS). Following HCC identification, CEUS can also be highly beneficial in treatment planning, delivery, and monitoring HCC response to locoregional therapies. Specific advantages of CEUS include providing real-time treatment guidance and improved diagnostic performance for the detection of residual tumor viability or recurrence, thereby identifying patients in need of retreatment substantially earlier than contrast-enhanced CT and MRI. This review provides a primer on ultrasound and CEUS for the screening and characterization of HCC, with an emphasis on assessing tumor response to locoregional therapies.
Collapse
Affiliation(s)
- John R Eisenbrey
- Department of Radiology, Thomas Jefferson University, 132 South 10th St, 796E Main Building, Philadelphia, PA, 19107, USA.
| | - Helena Gabriel
- Department of Radiology, Northwestern University, Chicago, IL, USA
| | - Esika Savsani
- Department of Radiology, Thomas Jefferson University, 132 South 10th St, 796E Main Building, Philadelphia, PA, 19107, USA
| | - Andrej Lyshchik
- Department of Radiology, Thomas Jefferson University, 132 South 10th St, 796E Main Building, Philadelphia, PA, 19107, USA
| |
Collapse
|
15
|
Mauri G, Monfardini L, Della Vigna P, Montano F, Bonomo G, Buccimazza G, Camisassi N, Rossi D, Maiettini D, Varano GM, Solbiati L, Orsi F. Real-Time US-CT fusion imaging for guidance of thermal ablation in of renal tumors invisible or poorly visible with US: results in 97 cases. Int J Hyperthermia 2021; 38:771-776. [PMID: 33971779 DOI: 10.1080/02656736.2021.1923837] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
PURPOSE To assess the capability of ultrasound-computed tomography (US-CT) fusion imaging to guide a precise targeting of renal tumors invisible or poorly visible with US. MATERIALS AND METHODS From 2016 renal tumors poorly visible or inconspicuous/invisible at US were treated at our institution with the guidance of US/CT fusion in a room equipped with CT scanner. Feasibility of the procedure, accuracy of targeting, complications, and technique efficacy were evaluated. RESULTS Of 227 patients treated from 2016 to March 2020, 91 patients (65 males and 26 females, mean age 68.5 ± 10.1 years) with 97 renal lesions (mean maximum diameter 21.6 ± 9.4 mm) inconspicuous/invisible (29/97, 29.9%) or poorly visible (68/97, 70.1%) at US underwent treatment under US-CT fusion guidance. US-CT fusion imaging guidance was always technically feasible and enabled correct targeting in 97/97/(100%) of cases. Technical success was achieved in 93/97 lesions (95.9%). Three lesions were retreated during the same ablative session, while 1 was retreated in a subsequent session. Thus, primary efficacy was achieved in one session in 96/97 (98.9%) cases and secondary efficacy in 97/97 (100%) cases. CONCLUSION US-CT image fusion guidance allows for a correct tumor targeting of renal tumors poorly visible or inconspicuous/invisible with US alone, with a high rate of technical success and technique efficacy.
Collapse
Affiliation(s)
- Giovanni Mauri
- Division of Interventional Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hematology-Oncology, Università degli Studi di Milano, Milan, Italy
| | | | - Paolo Della Vigna
- Division of Interventional Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Florian Montano
- Division of Interventional Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Post-graduate School in Radiodiagnostics, Università degli Studi di Milano, Milan, Italy
| | - Guido Bonomo
- Division of Interventional Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Giorgio Buccimazza
- Division of Interventional Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Post-graduate School in Radiodiagnostics, Università degli Studi di Milano, Milan, Italy
| | - Nicola Camisassi
- Division of Interventional Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Duccio Rossi
- Division of Interventional Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Post-graduate School in Radiodiagnostics, Università degli Studi di Milano, Milan, Italy
| | - Daniele Maiettini
- Division of Interventional Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Gianluca Maria Varano
- Division of Interventional Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Luigi Solbiati
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy.,Department of Radiology, Humanitas Clinical and Research Hospital, Rozzano, Italy
| | - Franco Orsi
- Division of Interventional Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| |
Collapse
|
16
|
Meloni MF, Francica G, Chiang J, Coltorti A, Danzi R, Laeseke PF. Use of Contrast-Enhanced Ultrasound in Ablation Therapy of HCC: Planning, Guiding, and Assessing Treatment Response. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2021; 40:879-894. [PMID: 32936485 DOI: 10.1002/jum.15471] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 07/23/2020] [Indexed: 06/11/2023]
Abstract
Contrast-enhanced ultrasonography (CEUS) plays an important role in the management of patients treated with ablation therapies, in the diagnostic, therapeutic and monitoring phases. Compared to contrast-enhanced computed tomography and contrast-enhanced magnetic resonance imaging, CEUS presents several advantages in imaging HCC, including real time imaging capability, high sensitivity for tumor vascularity, absence of renal toxicity, no ionizing radiation, repeatability of injections, good compliance by the patient and low cost. The purpose of this review is to evaluate the role of CEUS in the management of the patients with HCC treated with ablation therapies and describe how in our protocol CEUS is integrated with the other imaging modalities such as contrast-enhanced computed tomography and contrast-enhanced magnetic resonance imaging.
Collapse
Affiliation(s)
- Maria Franca Meloni
- Radiology Department, University of Pavia, Italy and Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA
| | - Giampiero Francica
- Interventional Ultrasound Unit, Pineta Grande Hospital, Castel Volturno, Italy
| | - Jason Chiang
- Department of Radiology, Ronald Reagan UCLA Medical Center, Los Angeles, USA
| | - Andrea Coltorti
- Department of Radiology, Federico II University, Naples, Italy
| | - Roberta Danzi
- Department of Radiology, Pineta Grande Hospital, Castel Volturno, Italy
| | - Paul F Laeseke
- Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA
| |
Collapse
|
17
|
Imaging and Image-Guided Thermal Ablation for Oligometastatic Colorectal Cancer Liver Disease. ACTA ACUST UNITED AC 2021; 26:124-128. [PMID: 32205536 DOI: 10.1097/ppo.0000000000000440] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Colorectal cancer affects more than 1 million people worldwide, and half of this population develops liver metastases. Image-guided thermal ablation is an acceptable local therapy for the management of oligometastatic colorectal cancer liver disease, in patients who are noneligible for surgery, or present with recurrence after hepatectomy. Continuous technological evolutions, understanding of tumor variability through disease biology and genetics, and optimization of ablation parameters with ablation margin assessment have allowed patients with resectable small-volume disease to be treated by thermal ablation with curative intent. The growing role of imaging and image guidance in thermal ablation for patient selection, procedure planning, tumor targeting, and assessment of technical success is discussed in this article.
Collapse
|
18
|
Malone CD, Fetzer DT, Monsky WL, Itani M, Mellnick VM, Velez PA, Middleton WD, Averkiou MA, Ramaswamy RS. Contrast-enhanced US for the Interventional Radiologist: Current and Emerging Applications. Radiographics 2021; 40:562-588. [PMID: 32125955 DOI: 10.1148/rg.2020190183] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
US is a powerful and nearly ubiquitous tool in the practice of interventional radiology. Use of contrast-enhanced US (CEUS) has gained traction in diagnostic imaging given the recent approval by the U.S. Food and Drug Administration (FDA) of microbubble contrast agents for use in the liver, such as sulfur hexafluoride lipid-type A microspheres. Adoption of CEUS by interventional radiologists can enhance not only procedure guidance but also preprocedure patient evaluation and assessment of treatment response across a wide spectrum of oncologic, vascular, and nonvascular procedures. In addition, the unique physical properties of microbubble contrast agents make them amenable as therapeutic vehicles in themselves, which can lay a foundation for future therapeutic innovations in the field in drug delivery, thrombolysis, and vascular flow augmentation. The purpose of this article is to provide an introduction to and overview of CEUS aimed at the interventional radiologist, highlighting its role before, during, and after frequently practiced oncologic and vascular interventions such as biopsy, ablation, transarterial chemoembolization, detection and control of hemorrhage, evaluation of transjugular intrahepatic portosystemic shunts (TIPS), detection of aortic endograft endoleak, thrombus detection and evaluation, evaluation of vascular malformations, lymphangiography, and percutaneous drain placement. Basic physical principles of CEUS, injection and scanning protocols, and logistics for practice implementation are also discussed. Early adoption of CEUS by the interventional radiology community will ensure rapid innovation of the field and development of future novel procedures. Online supplemental material is available for this article. ©RSNA, 2020.
Collapse
Affiliation(s)
- Christopher D Malone
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, CB 8131, St Louis, MO 63110 (C.D.M., M.I., V.M.M., P.A.V., W.D.M., R.S.R.); Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (D.T.F.); Department of Radiology, University of Washington Medical Center, Seattle, Wash (W.L.M.); and Department of Bioengineering, University of Washington, Seattle, Wash (M.A.A.)
| | - David T Fetzer
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, CB 8131, St Louis, MO 63110 (C.D.M., M.I., V.M.M., P.A.V., W.D.M., R.S.R.); Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (D.T.F.); Department of Radiology, University of Washington Medical Center, Seattle, Wash (W.L.M.); and Department of Bioengineering, University of Washington, Seattle, Wash (M.A.A.)
| | - Wayne L Monsky
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, CB 8131, St Louis, MO 63110 (C.D.M., M.I., V.M.M., P.A.V., W.D.M., R.S.R.); Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (D.T.F.); Department of Radiology, University of Washington Medical Center, Seattle, Wash (W.L.M.); and Department of Bioengineering, University of Washington, Seattle, Wash (M.A.A.)
| | - Malak Itani
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, CB 8131, St Louis, MO 63110 (C.D.M., M.I., V.M.M., P.A.V., W.D.M., R.S.R.); Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (D.T.F.); Department of Radiology, University of Washington Medical Center, Seattle, Wash (W.L.M.); and Department of Bioengineering, University of Washington, Seattle, Wash (M.A.A.)
| | - Vincent M Mellnick
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, CB 8131, St Louis, MO 63110 (C.D.M., M.I., V.M.M., P.A.V., W.D.M., R.S.R.); Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (D.T.F.); Department of Radiology, University of Washington Medical Center, Seattle, Wash (W.L.M.); and Department of Bioengineering, University of Washington, Seattle, Wash (M.A.A.)
| | - Philip A Velez
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, CB 8131, St Louis, MO 63110 (C.D.M., M.I., V.M.M., P.A.V., W.D.M., R.S.R.); Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (D.T.F.); Department of Radiology, University of Washington Medical Center, Seattle, Wash (W.L.M.); and Department of Bioengineering, University of Washington, Seattle, Wash (M.A.A.)
| | - William D Middleton
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, CB 8131, St Louis, MO 63110 (C.D.M., M.I., V.M.M., P.A.V., W.D.M., R.S.R.); Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (D.T.F.); Department of Radiology, University of Washington Medical Center, Seattle, Wash (W.L.M.); and Department of Bioengineering, University of Washington, Seattle, Wash (M.A.A.)
| | - Michalakis A Averkiou
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, CB 8131, St Louis, MO 63110 (C.D.M., M.I., V.M.M., P.A.V., W.D.M., R.S.R.); Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (D.T.F.); Department of Radiology, University of Washington Medical Center, Seattle, Wash (W.L.M.); and Department of Bioengineering, University of Washington, Seattle, Wash (M.A.A.)
| | - Raja S Ramaswamy
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, CB 8131, St Louis, MO 63110 (C.D.M., M.I., V.M.M., P.A.V., W.D.M., R.S.R.); Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (D.T.F.); Department of Radiology, University of Washington Medical Center, Seattle, Wash (W.L.M.); and Department of Bioengineering, University of Washington, Seattle, Wash (M.A.A.)
| |
Collapse
|
19
|
Filippiadis DK, Velonakis G, Kelekis A, Sofocleous CT. The Role of Percutaneous Ablation in the Management of Colorectal Cancer Liver Metastatic Disease. Diagnostics (Basel) 2021; 11:308. [PMID: 33672993 PMCID: PMC7918461 DOI: 10.3390/diagnostics11020308] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/09/2021] [Accepted: 02/11/2021] [Indexed: 12/22/2022] Open
Abstract
Approximately 50% of colorectal cancer patients will develop metastases during the course of the disease. Local or locoregional therapies for the treatment of liver metastases are used in the management of oligometastatic colorectal liver disease, especially in nonsurgical candidates. Thermal ablation (TA) is recommended in the treatment of limited liver metastases as free-standing therapy or in combination with surgery as long as all visible disease can be eradicated. Percutaneous TA has been proven as a safe and efficacious therapy offering sustained local tumor control and improved patient survival. Continuous technological advances in diagnostic imaging and guidance tools, the evolution of devices allowing for optimization of ablation parameters, as well as the ability to perform margin assessment have improved the efficacy of ablation. This allows resectable small volume diseases to be cured with percutaneous ablation. The ongoing detailed information and increasing understanding of tumor biology, genetics, and tissue biomarkers that impact oncologic outcomes as well as their implications on the results of ablation have further allowed for treatment customization and improved oncologic outcomes even in those with more aggressive tumor biology. The purpose of this review is to present the most common indications for image-guided percutaneous ablation in colorectal cancer liver metastases, to describe technical considerations, and to discuss relevant peer-reviewed evidence on this topic. The growing role of imaging and image-guidance as well as controversies regarding several devices are addressed.
Collapse
Affiliation(s)
- Dimitrios K. Filippiadis
- 2nd Department of Radiology, Medical School, University General Hospital “ATTIKON”, National and Kapodistrian University of Athens, 12462 Athens, Greece; (G.V.); (A.K.)
| | - Georgios Velonakis
- 2nd Department of Radiology, Medical School, University General Hospital “ATTIKON”, National and Kapodistrian University of Athens, 12462 Athens, Greece; (G.V.); (A.K.)
| | - Alexis Kelekis
- 2nd Department of Radiology, Medical School, University General Hospital “ATTIKON”, National and Kapodistrian University of Athens, 12462 Athens, Greece; (G.V.); (A.K.)
| | | |
Collapse
|
20
|
Assessing ablation margins of FDG-avid liver tumors during PET/CT-guided thermal ablation procedures: a retrospective study. Eur J Nucl Med Mol Imaging 2021; 48:2914-2924. [PMID: 33559712 DOI: 10.1007/s00259-021-05206-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 01/17/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND To retrospectively assess liver tumor ablation margins using intraprocedural PET/CT images from FDG PET/CT-guided microwave or cryoablation procedures and to correlate minimum margin measurements with local progression outcomes. METHODS Fifty-six patients (ages 36 to 85, median 62; 32 females) with 77 FDG-avid liver tumors underwent 60 FDG PET/CT guided, percutaneous microwave, or cryoablation procedures. Single breath-hold PET/CT images were used for intraprocedural assessment of the tumor ablation margin: liver tumors remained visible on PET immediately following ablation; microwave ablation zones were visible using contrast-enhanced CT; cryoablation zones (ice balls) were visible using unenhanced CT. Two readers retrospectively determined ablation margin assessability and measured the minimum ablation margin on intraprocedural PET/CT (n = 77) and postprocedural MRI (n = 56). Local tumor progression was assessed on all available follow-up imaging (1-49 months, mean 15). Local tumor progression was correlated with PET/CT minimum margin measurements using clustered survival models for 61 tumors. RESULTS Minimum ablation margins were more often assessable using intraprocedural PET/CT (≥ 73/77 tumors, 95%) than postprocedural MRI (≤ 35/56 tumors, 63%). In 61 tumors with PET/CT-assessable margins (excluding tumors with overlapping ablations after PET/CT), there was a 6-fold increased risk of local tumor progression [hazard ratio (HR) 6.05; P = 0.004] for minimum ablation margins < 5 mm. CONCLUSION Breath-hold PET/CT scans, during PET/CT-guided microwave or cryoablation procedures for FDG-avid liver tumors, enable reliable intraprocedural assessment of the entire tumor ablation margin; a minimum PET/CT ablation margin threshold of 5 mm correlates well with local tumor progression outcomes.
Collapse
|
21
|
Contrast-enhanced ultrasound imaging of the liver: a review of the clinical evidence for SonoVue and Sonazoid. Abdom Radiol (NY) 2020; 45:3779-3788. [PMID: 32424608 DOI: 10.1007/s00261-020-02573-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Contrast-enhanced ultrasound (CEUS) has become an established modality in various clinical indications for liver diseases. SonoVue®, a pure blood pure agent, and Sonazoid®, which exhibits an additional Kupffer phase, are contrast agents approved for liver imaging. This review discusses and compares the current clinical evidence for these two ultrasound contrast agents in the characterization and detection of focal liver lesions in the non-cirrhotic and cirrhotic liver, as well as for the use in interventional procedures such as liver biopsy guidance, and local ablation treatment monitoring. Reference is made to clinical studies which evaluated the accuracy of CEUS using a standard of reference, its safety, or to comparative studies of these two agents.
Collapse
|
22
|
Dietrich CF, Nolsøe CP, Barr RG, Berzigotti A, Burns PN, Cantisani V, Chammas MC, Chaubal N, Choi BI, Clevert DA, Cui X, Dong Y, D'Onofrio M, Fowlkes JB, Gilja OH, Huang P, Ignee A, Jenssen C, Kono Y, Kudo M, Lassau N, Lee WJ, Lee JY, Liang P, Lim A, Lyshchik A, Meloni MF, Correas JM, Minami Y, Moriyasu F, Nicolau C, Piscaglia F, Saftoiu A, Sidhu PS, Sporea I, Torzilli G, Xie X, Zheng R. Guidelines and Good Clinical Practice Recommendations for Contrast Enhanced Ultrasound (CEUS) in the Liver - Update 2020 - WFUMB in Cooperation with EFSUMB, AFSUMB, AIUM, and FLAUS. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2020; 41:562-585. [PMID: 32707595 DOI: 10.1055/a-1177-0530] [Citation(s) in RCA: 106] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
The present, updated document describes the fourth iteration of recommendations for the hepatic use of contrast enhanced ultrasound (CEUS), first initiated in 2004 by the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB). The previous updated editions of the guidelines reflected changes in the available contrast agents and updated the guidelines not only for hepatic but also for non-hepatic applications.The 2012 guideline requires updating as previously the differences of the contrast agents were not precisely described and the differences in contrast phases as well as handling were not clearly indicated. In addition, more evidence has been published for all contrast agents. The update also reflects the most recent developments in contrast agents, including the United States Food and Drug Administration (FDA) approval as well as the extensive Asian experience, to produce a truly international perspective.These guidelines and recommendations provide general advice on the use of ultrasound contrast agents (UCA) and are intended to create standard protocols for the use and administration of UCA in liver applications on an international basis to improve the management of patients.
Collapse
Affiliation(s)
- Christoph F Dietrich
- Department Allgemeine Innere Medizin (DAIM), Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
- Johann Wolfgang Goethe Universitätsklinik Frankfurt, Germany
| | - Christian Pállson Nolsøe
- Center for Surgical Ultrasound, Dep of Surgery, Zealand University Hospital, Køge. Copenhagen Academy for Medical Education and Simulation (CAMES). University of Copenhagen, Denmark
| | - Richard G Barr
- Department of Radiology, Northeastern Ohio Medical University, Rootstown, Ohio, USA and Southwoods Imaging, Youngstown, Ohio, USA
| | - Annalisa Berzigotti
- Hepatology, University Clinic for Visceral Surgery and Medicine, DBMR, Inselspital, University of Bern, Switzerland
| | - Peter N Burns
- Dept Medical Biophysics, University of Toronto, Imaging Research, Sunnybrook Research Institute, Toronto
| | - Vito Cantisani
- Uos Ecografia Internistico-chirurgica, Dipartimento di Scienze Radiologiche, Oncologiche, Anatomo-Patologiche, Policlinico Umberto I, Univ. Sapienza, Rome, Italy
| | - Maria Cristina Chammas
- Institute of Radiology, Hospital das Clínicas, School of Medicine, University of São Paulo, Brazil
| | - Nitin Chaubal
- Thane Ultrasound Centre, Jaslok Hospital and Research Centre, Mumbai, India
| | - Byung Ihn Choi
- Department of Radiology, Chung-Ang University Hospital, Seoul, Korea
| | - Dirk-André Clevert
- Interdisciplinary Ultrasound-Center, Department of Radiology, University of Munich-Grosshadern Campus, Munich, Germany
| | - Xinwu Cui
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan China
| | - Yi Dong
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Mirko D'Onofrio
- Department of Radiology, G.B. Rossi University Hospital, University of Verona, Verona, Italy
| | - J Brian Fowlkes
- Basic Radiological Sciences Division, Department of Radiology, University of Michigan Health System, Ann Arbor, MI, United States
| | - Odd Helge Gilja
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, and Department of Clinical Medicine, University of Bergen, Norway
| | - Pintong Huang
- Department of Ultrasound in Medicine, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Andre Ignee
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
| | - Christian Jenssen
- Krankenhaus Märkisch Oderland, Department of Internal Medicine, Strausberg/Wriezen, Germany
| | - Yuko Kono
- Departments of Medicine and Radiology, University of California, San Diego, USA
| | - Masatoshi Kudo
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Nathalie Lassau
- Imaging Department. Gustave Roussy and BIOMAPS. Université Paris-Saclay, Villejuif, France
| | - Won Jae Lee
- Department of Radiology and Center For Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. Departments of Health and Science and Technology and Medical Device Management and Research, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul, Korea
| | - Jae Young Lee
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Ping Liang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Adrian Lim
- Department of Imaging, Imperial College London and Healthcare NHS Trust, Charing Cross Hospital Campus, London United Kingdom
| | - Andrej Lyshchik
- Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA, United States
| | | | - Jean Michel Correas
- Service de Radiologie Adultes, Hôpital Necker, Université Paris Descartes, Paris, France
| | - Yasunori Minami
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Fuminori Moriyasu
- Center for Cancer Ablation Therapy, Sanno Hospital, International University of Health and Welfare, Tokyo, Japan
| | - Carlos Nicolau
- Radiology Department, Hospital Clinic. University of Barcelona, Barcelona, Spain
| | - Fabio Piscaglia
- Unit of Internal Medicine, Dept of Medical and Surgical Sciences, University of Bologna S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Adrian Saftoiu
- Research Center of Gastroenterology and Hepatology Craiova, University of Medicine and Pharmacy Craiova, Romania
| | - Paul S Sidhu
- Department of Radiology, King's College Hospital, King's College London, London
| | - Ioan Sporea
- Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania
| | - Guido Torzilli
- Department of Surgery, Division of Hepatobiliary & General Surgery, Humanitas University & Research Hospital, Rozzano, Milano, Italy
| | - Xiaoyan Xie
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Rongqin Zheng
- Department of Ultrasound, The 3rd Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
23
|
Dietrich CF, Nolsøe CP, Barr RG, Berzigotti A, Burns PN, Cantisani V, Chammas MC, Chaubal N, Choi BI, Clevert DA, Cui X, Dong Y, D'Onofrio M, Fowlkes JB, Gilja OH, Huang P, Ignee A, Jenssen C, Kono Y, Kudo M, Lassau N, Lee WJ, Lee JY, Liang P, Lim A, Lyshchik A, Meloni MF, Correas JM, Minami Y, Moriyasu F, Nicolau C, Piscaglia F, Saftoiu A, Sidhu PS, Sporea I, Torzilli G, Xie X, Zheng R. Guidelines and Good Clinical Practice Recommendations for Contrast-Enhanced Ultrasound (CEUS) in the Liver-Update 2020 WFUMB in Cooperation with EFSUMB, AFSUMB, AIUM, and FLAUS. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:2579-2604. [PMID: 32713788 DOI: 10.1016/j.ultrasmedbio.2020.04.030] [Citation(s) in RCA: 201] [Impact Index Per Article: 50.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 04/16/2020] [Accepted: 04/24/2020] [Indexed: 05/14/2023]
Abstract
The present, updated document describes the fourth iteration of recommendations for the hepatic use of contrast-enhanced ultrasound, first initiated in 2004 by the European Federation of Societies for Ultrasound in Medicine and Biology. The previous updated editions of the guidelines reflected changes in the available contrast agents and updated the guidelines not only for hepatic but also for non-hepatic applications. The 2012 guideline requires updating as, previously, the differences in the contrast agents were not precisely described and the differences in contrast phases as well as handling were not clearly indicated. In addition, more evidence has been published for all contrast agents. The update also reflects the most recent developments in contrast agents, including U.S. Food and Drug Administration approval and the extensive Asian experience, to produce a truly international perspective. These guidelines and recommendations provide general advice on the use of ultrasound contrast agents (UCAs) and are intended to create standard protocols for the use and administration of UCAs in liver applications on an international basis to improve the management of patients.
Collapse
Affiliation(s)
- Christoph F Dietrich
- Department Allgemeine Innere Medizin (DAIM), Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland; Johann Wolfgang Goethe Universitätsklinik, Frankfurt, Germany.
| | - Christian Pállson Nolsøe
- Center for Surgical Ultrasound, Dep of Surgery, Zealand University Hospital, Køge. Copenhagen Academy for Medical Education and Simulation (CAMES). University of Copenhagen, Denmark
| | - Richard G Barr
- Department of Radiology, Northeastern Ohio Medical University, Rootstown, Ohio, USA; Southwoods Imaging, Youngstown, Ohio, USA
| | - Annalisa Berzigotti
- Hepatology, University Clinic for Visceral Surgery and Medicine, DBMR, Inselspital, University of Bern, Switzerland
| | - Peter N Burns
- Department of Medical Biophysics, University of Toronto, Imaging Research, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Vito Cantisani
- Uos Ecografia Internistico-chirurgica, Dipartimento di Scienze Radiologiche, Oncologiche, Anatomo-Patologiche, Policlinico Umberto I, Univ. Sapienza, Rome, Italy
| | - Maria Cristina Chammas
- Institute of Radiology, Hospital das Clínicas, School of Medicine, University of São Paulo, Brazil
| | - Nitin Chaubal
- Thane Ultrasound Centre, Jaslok Hospital and Research Centre, Mumbai, India
| | - Byung Ihn Choi
- Department of Radiology, Chung-Ang University Hospital, Seoul, Korea
| | - Dirk-André Clevert
- Interdisciplinary Ultrasound-Center, Department of Radiology, University of Munich-Grosshadern Campus, Munich, Germany
| | - Xinwu Cui
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Dong
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Mirko D'Onofrio
- Department of Radiology, G. B. Rossi University Hospital, University of Verona, Verona, Italy
| | - J Brian Fowlkes
- Basic Radiological Sciences Division, Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Odd Helge Gilja
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, and Department of Clinical Medicine, University of Bergen, Norway
| | - Pintong Huang
- Department of Ultrasound in Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Andre Ignee
- Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
| | - Christian Jenssen
- Krankenhaus Märkisch Oderland, Department of Internal Medicine, Strausberg/Wriezen, Germany
| | - Yuko Kono
- Departments of Medicine and Radiology, University of California, San Diego, California, USA
| | - Masatoshi Kudo
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Nathalie Lassau
- Imaging Department, Gustave Roussy and BIOMAPS, Université Paris-Saclay, Villejuif, France
| | - Won Jae Lee
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Departments of Health and Science and Technology and Medical Device Management and Research, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul, Korea
| | - Jae Young Lee
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Ping Liang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Adrian Lim
- Department of Imaging, Imperial College London and Healthcare NHS Trust, Charing Cross Hospital Campus, London, United Kingdom
| | - Andrej Lyshchik
- Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | | | - Jean Michel Correas
- Service de Radiologie Adultes, Hôpital Necker, Université Paris Descartes, Paris, France
| | - Yasunori Minami
- Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Fuminori Moriyasu
- Center for Cancer Ablation Therapy, Sanno Hospital, International University of Health and Welfare, Tokyo, Japan
| | - Carlos Nicolau
- Radiology Department, Hospital Clinic. University of Barcelona, Barcelona, Spain
| | - Fabio Piscaglia
- Unit of Internal Medicine, Department of Medical and Surgical Sciences, University of Bologna S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Adrian Saftoiu
- Research Center of Gastroenterology and Hepatology Craiova, University of Medicine and Pharmacy Craiova, Romania
| | - Paul S Sidhu
- Department of Radiology, King's College Hospital, King's College London, London, United Kingdom
| | - Ioan Sporea
- Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania
| | - Guido Torzilli
- Department of Surgery, Division of Hepatobiliary & General Surgery, Humanitas University & Research Hospital, Rozzano, Milan, Italy
| | - Xiaoyan Xie
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Rongqin Zheng
- Department of Ultrasound, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| |
Collapse
|
24
|
|
25
|
Jin T, Liu X, Zhang H, Cao Y, Dai C, Tang S, Xu F. Ultrasound-guided percutaneous microwave ablation for hepatocellular carcinoma adjacent to large vessels: a propensity score matching analysis. Int J Hyperthermia 2020; 37:955-964. [PMID: 32781862 DOI: 10.1080/02656736.2020.1804076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
PURPOSE This study aimed to compare the efficacy and safety of ultrasound-guided percutaneous microwave ablation (MWA) for hepatocellular carcinoma (HCC) adjacent to large vessels with those far from large vessels. METHODS The clinical data of patients who underwent ultrasound-guided percutaneous MWA for HCC were retrospectively analyzed between January 2011 and December 2018 in Shengjing Hospital. Patients with HCC adjacent to large vessels were included in the Vessel group, the remaining patients were included in the Control group. Propensity score matching analysis was used to reduce confounding bias. The rates of complete ablation, local recurrence, recurrence-free survival (RFS), overall survival (OS) and complications were compared between the two groups. RESULTS A total of 134 patients with 157 nodules (size range, 0.6-3.8 cm) were enrolled in this study, 23 in the Vessel group and 111 in the Control group. A total of 21 patients in the Vessel group (91.3%) and 105 patients in the Control group (94.6%) achieved complete ablation (p = .902). Following 1:2 propensity score matching, 22 patients were included in the Vessel group and 40 patients were enrolled in the Control group. Local recurrence was observed in 2 (9.1%) patients in the Vessel group and 5 (12.5%) in the Control group (p = .86). No significant difference in local recurrence rate, RFS and OS were observed between the two groups. CONCLUSIONS Ultrasound-guided percutaneous MWA appears to be a safe procedure and can achieve comparable oncological efficacy for HCC abutting large vessels.
Collapse
Affiliation(s)
- Tianqiang Jin
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiaolin Liu
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, China.,Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Heyue Zhang
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yuqing Cao
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Chaoliu Dai
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Shaoshan Tang
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Feng Xu
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, China
| |
Collapse
|
26
|
Mauri G, Rossi D, Bonomo G, Camisassi N, Della Vigna P, Maiettini D, Varano GM, Monfardini L, Mascagni L, Orsi F. Image-guided thermal ablation of central renal tumors with retrograde cold pyeloperfusion technique: a monocentric experience. Int J Hyperthermia 2020; 37:660-667. [PMID: 32552069 DOI: 10.1080/02656736.2020.1778801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Purpose: To evaluate feasibility, safety and efficacy of image-guided thermal ablations associated with retrograde pyeloperfusion in patients with centrally located renal tumors.Materials and methods: 48 patients (15 women, 33 men, mean age 69.1 ± 11.8) were treated with image-guided thermal ablation associated with pyeloperfusion for 58 centrally located renal tumors (mean diameter 32.3 ± 7.32 mm). 7 patients had a single kidney. Microwave and radiofrequency ablation were used. All treatments were performed with ultrasound, CT, or fusion imaging guidance under general anesthesia and simultaneous retrograde cold pyeloperfusion technique.Results: Procedure was feasible in all cases. Technical success and primary technical efficacy were reached in 51/58 (88%) and 45/54 tumors (83%). With a second ablation performed in 5 tumors, secondary technical efficacy was achieved in 50/50 (100%) tumors. Minor and major complications occurred in 8/58 (13%) and 5/58 (8%) tumors. No significative change in renal function occurred after treatment.During follow-up, 5 recurrences occurred, that were retreated with a second ablation. At last follow up (mean 32.2 ± 22.0 months), 41/48 (85%) treated patients were free from disease. The median TTP and PFS were 27.0 (range, 2.3-80.0) and 26.5 months (range, 2.3-80.0), respectively.Conclusion: Image-guided thermal ablation associated with protective pyeloperfusion is a feasible, safe, and effective treatment option for patients with central renal tumors with a minimal impact on renal function and relevant potential to avoid nephrectomy.
Collapse
Affiliation(s)
- Giovanni Mauri
- Department of Oncology and Hematology-Oncology, Università Degli Studi di Milano, Milan, Italy.,Division of Interventional Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Duccio Rossi
- Postgraduate School of Radiodiagnostics, Università Degli Studi di Milano, Milan, Italy
| | - Guido Bonomo
- Division of Interventional Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Nicola Camisassi
- Division of Interventional Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Paolo Della Vigna
- Division of Interventional Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Daniele Maiettini
- Division of Interventional Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Gianluca Maria Varano
- Division of Interventional Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Lorenzo Monfardini
- Dipartimento di Radiologia, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
| | - Luca Mascagni
- Radiology Residency, School of Medicine and Psychology, "Sapienza" University, Rome, Italy
| | - Franco Orsi
- Division of Interventional Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| |
Collapse
|
27
|
Filippiadis D, Mauri G, Marra P, Charalampopoulos G, Gennaro N, De Cobelli F. Percutaneous ablation techniques for renal cell carcinoma: current status and future trends. Int J Hyperthermia 2020; 36:21-30. [PMID: 31537160 DOI: 10.1080/02656736.2019.1647352] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Percutaneous ablation is an increasingly applied technique for the treatment of localized renal tumors, especially for elderly or co-morbid patients, where co-morbidities increase the risk of traditional nephrectomy. Ablative techniques are technically suited for the treatment of tumors generally not exceeding 4 cm, which has been set as general consensus cutoff and is described as the upper threshold of T1a kidney tumors. This threshold cutoff is being challenged, but with still limited evidence. Percutaneous ablation techniques for the treatment of renal cell carcinoma (RCC) include radiofrequency ablation, cryoablation, laser or microwave ablation; the main advantage of all these techniques over surgery is less invasiveness, lower complication rates and better patient tolerability. Currently, international guidelines recommend percutaneous ablation either as intervention for frail patients or as a first line tool, provided that the tumor can be radically ablated. The purpose of this article is to describe the basic concepts of percutaneous ablation in the treatment of RCC. Controversies concerning techniques and products and the need for patient-centered tailored approaches during selection among the different techniques available will be discussed.
Collapse
Affiliation(s)
- D Filippiadis
- 2nd Department of Radiology, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens , Athens , Greece
| | - G Mauri
- Division of Interventional Radiology, European Institute of Oncology, IRCCS , Milan , Italy
| | - P Marra
- Clinical and Experimental Radiology Unit, Experimental Imaging Center, San Raffaele Scientific Institute , Milan , Italy
| | - G Charalampopoulos
- 2nd Department of Radiology, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens , Athens , Greece
| | - N Gennaro
- Division of Interventional Radiology, European Institute of Oncology, IRCCS , Milan , Italy
| | - F De Cobelli
- Clinical and Experimental Radiology Unit, Experimental Imaging Center, San Raffaele Scientific Institute , Milan , Italy
| |
Collapse
|
28
|
Abstract
Image-guided percutaneous thermal ablation is a widely acceptable local therapy for patients with colorectal liver metastases who are noneligible for surgery or present with recurrence after hepatectomy. The increasing knowledge of factors that affect oncologic outcomes has allowed selected patients with resectable small volume colorectal liver metastases to be treated by thermal ablation with curative intent. The continuous technological evolutions in imaging and image-guidance and the wide implementation of microwave ablation that overcomes most of the limitations of radiofrequency ablation have contributed to this paradigm shift. The importance of patient selection, ablation margin evaluation, and confirmation of complete tumor ablation (A0) are discussed in this article.
Collapse
|
29
|
Reproducibility of Ablated Volume Measurement Is Higher with Contrast-Enhanced Ultrasound than with B-Mode Ultrasound after Benign Thyroid Nodule Radiofrequency Ablation-A Preliminary Study. J Clin Med 2020; 9:jcm9051504. [PMID: 32429487 PMCID: PMC7291258 DOI: 10.3390/jcm9051504] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 05/12/2020] [Accepted: 05/13/2020] [Indexed: 12/17/2022] Open
Abstract
The reproducibility of contrast-enhanced ultrasound (CEUS) and standard B-mode ultrasound in the assessment of radiofrequency-ablated volume of benign thyroid nodules was compared. A preliminary study was conducted on consecutive patients who underwent radiofrequency ablation (RFA) of benign thyroid nodules between 2014 and 2016, with available CEUS and B-mode post-ablation checks. CEUS and B-mode images were retrospectively evaluated by two radiologists to assess inter- and intra-observer agreement in the assessment of ablated volume (Bland–Altman test). For CEUS, the mean inter-observer difference (95% limits of agreement) was 0.219 mL (-0.372–0.809 mL); for B-mode, the mean difference was 0.880 mL (-1.655–3.414 mL). Reproducibility was significantly higher for CEUS (85%) than for B-mode (27%). Mean intra-observer differences (95% limits of agreement) were 0.013 mL (0.803–4.097 mL) for Reader 1 and 0.031 mL (0.763–3.931 mL) for Reader 2 using CEUS, while they were 0.567 mL (-2.180–4.317 mL, Reader 1) and 0.759 mL (-2.584–4.290 mL, Reader 2) for B-mode. Intra-observer reproducibility was significantly higher for CEUS (96% and 95%, for the two readers) than for B-mode (21% and 23%). In conclusion, CEUS had higher reproducibility and inter- and intra-observer agreement compared to conventional B-mode in the assessment of radiofrequency-ablated volume of benign thyroid nodules.
Collapse
|
30
|
Intracavitary contrast-enhanced ultrasound in ultrasound-guided percutaneous management of abdominal fluid collections/abscesses by a single clinician: an example of point-of-care ultrasound. J Ultrasound 2020; 23:175-181. [PMID: 32361920 DOI: 10.1007/s40477-020-00467-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 04/20/2020] [Indexed: 12/21/2022] Open
Abstract
PURPOSE To assess the role of intracavitary contrast-enhanced ultrasound (IC-CEUS) as a focused ultrasound (US) examination aimed at supporting a single physician in the management of interventional procedures for abdominal fluid collections/abscesses. METHODS In 43 patients (27 M/16 F, median age 68 years, range 35-91), a single physician performed catheter drainage (42) or needle aspiration (3) for the following: 14 infected abdominal fluid collections, 11 non-infected abdominal fluid collections, 9 pyogenic liver abscesses, 8 gallbladder empyema, and 3 infected pancreatic fluid collections. IC-CEUS (0.1-0.2 mL of SonoVue in 20 mL of saline) was carried out during catheter/needle placement and during the follow-up for catheters left in place. RESULTS Immediate IC-CEUS allowed to verify the (1) correct positioning of the needle/catheter inside the target in all cases and (2) communication with adjacent structures so as to choose a proper treatment in 21% of the cases. Follow-up IC-CEUS aided in the management of 40 catheters left in place. Appropriate treatment was implemented in 19.3% of the cases because of the presence of biliary fistulas and gallbladder perforation. IC-CEUS helped the physician with the appropriate timing of catheter removal by providing information on catheter malfunction (due to obstruction/dislodgement) and the size of residual undrained cavities. No side effects were registered following IC-CEUS. CONCLUSION Even if not strictly performed at bedside, IC-CEUS may represent an example of point-of-care ultrasound since it allows an interventional clinician to assess needle/catheter placement success, make treatment decisions, and choose the optimal timing for catheter removal with low costs and without side effects.
Collapse
|
31
|
Lin Z, Chen J, Yan Y, Chen J, Li Y. Microwave ablation of hepatic malignant tumors using 1.5T MRI guidance and monitoring: feasibility and preliminary clinical experience. Int J Hyperthermia 2020; 36:1216-1222. [PMID: 31814474 DOI: 10.1080/02656736.2019.1690166] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Purpose: To evaluate the feasibility and therapeutic efficacy of 1.5-T MRI-guided and monitored microwave ablation in patients with hepatic malignant tumors.Materials and Methods: This retrospective study was approved by the ethics committee of the First Affiliated Hospital of Fujian Medical University. Thirty-five patients (32 men, three women) with 48 lesions (maximum diameter < 3 cm) underwent microwave ablation under the guidance and monitoring of a 1.5-T MRI. The MRI-compatible microwave generator was appended with a magnetic shield case, and the cable was combined with a choke coil for shielding the Larmor processing frequency. The average age of the patients was 56.51 ± 11.36 years (31-77 years). Twenty-eight patients (37 lesions) displayed hepatocellular carcinoma and seven patients (11 lesions) had metastatic liver carcinoma. The mean maximum tumor diameter was 12.31 ± 4.72 mm (range 5.0-25.7 mm).Results: MRI scans were performed simultaneously without electromagnetic interference during ablation. The average maximum diameter of the hypointense zone of the last monitored T2WI sequence, hypointense zone of post-procedure T2WI sequence, and hyperintense zone of post-procedure T1WI were 28.82 ± 7.58 mm, 29.79 ± 7.91 mm, and 28.28 ± 8.37 mm, respectively, with no observed statistical difference (F = 0.434, p = .649). The technical success rate was 100%. The average follow-up duration was 11.43 ± 5.29 (4-33) months. The technique efficacy rate was 100%.Conclusion: MRI-guided and monitored microwave ablation of hepatic malignant tumors is feasible and potentially safe and effective.Key pointsMRI-guided microwave ablation of hepatic malignant tumors is feasible.The MRI monitoring scan could accurately reflect the scope of ablation lesion.On T1WI, the ablation lesions of liver showed the 'target sign'.
Collapse
Affiliation(s)
- Zhengyu Lin
- The Department of Interventional Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Jin Chen
- The Department of Interventional Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Yuan Yan
- The Department of Interventional Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Jian Chen
- The Department of Interventional Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Yuliang Li
- The Department of Interventional Radiology, The Second Hospital of Shandong University, Jinan, China
| |
Collapse
|
32
|
Pohlman RM, Varghese T. Physiological Motion Reduction Using Lagrangian Tracking for Electrode Displacement Elastography. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:766-781. [PMID: 31806499 PMCID: PMC7241290 DOI: 10.1016/j.ultrasmedbio.2019.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 09/19/2019] [Accepted: 11/04/2019] [Indexed: 05/03/2023]
Abstract
Minimally invasive treatments such as microwave ablation (MWA) have been growing in popularity for extending liver cancer survival rates in patients, when surgery is not an option. As a non-ionizing, real-time alternative to contrast-enhanced computed tomography, electrode displacement elastography (EDE) has shown promise as an imaging modality for MWA. Despite imaging efficacy, motion artifacts caused by physiological motion result in unintended speckle pattern variance, thereby inhibiting consistent and accurate ablated region visualization. To combat these unavoidable motion artifacts, a Lagrangian deformation tracking (LDT) approach based on freehand EDE was developed to track tissue movement and better define tissue properties. For validating LDT efficacy, a spherical inclusion phantom as well as seven in vivo data sets were processed, and strain tensor images were compared with identical time sampled images estimated using a traditional Eulerian approach. In vivo results revealed greater consistency among visualized LDT strain tensor images, with segmented ablated regions exhibiting standard deviation reductions of up to 98% when compared with Eulerian strain tensor images. Additionally, Lagrangian strain tensor images provided Dice coefficient improvements up to 25%, and success rates improved from approximately 50% to nearly 100% for ablated region visualization.
Collapse
Affiliation(s)
- Robert M Pohlman
- Department of Electrical and Computer Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA; Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
| | - Tomy Varghese
- Department of Electrical and Computer Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA; Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| |
Collapse
|
33
|
Bartolotta TV, Terranova MC, Gagliardo C, Taibbi A. CEUS LI-RADS: a pictorial review. Insights Imaging 2020; 11:9. [PMID: 32020352 PMCID: PMC7000618 DOI: 10.1186/s13244-019-0819-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 11/21/2019] [Indexed: 12/12/2022] Open
Abstract
Contrast-enhanced ultrasound (CEUS) greatly improved the diagnostic accuracy of US in the detection and characterization of focal liver lesions (FLLs), and it is suggested and often included in many international guidelines as an important diagnostic tool in the imaging work-up of cirrhotic patients at risk for developing hepatocellular carcinoma (HCC). In particular, CEUS Liver Imaging Reporting and Data System (LI-RADS) provides standardized terminology, interpretation, and reporting for the diagnosis of HCC. The aim of this pictorial essay is to illustrate CEUS features of nodules discovered at US in cirrhotic liver according to LI-RADS categorization.
Collapse
Affiliation(s)
- Tommaso Vincenzo Bartolotta
- BiND Department: Biomedicine, Neuroscience and Advanced Diagnostic, University of Palermo, Via Del Vespro, 129 90127, Palermo, Italy. .,Department of Radiology, Fondazione Istituto Giuseppe Giglio Ct.da Pietrapollastra, Via Pisciotto, 90015, Cefalù (Palermo), Italy.
| | - Maria Chiara Terranova
- BiND Department: Biomedicine, Neuroscience and Advanced Diagnostic, University of Palermo, Via Del Vespro, 129 90127, Palermo, Italy
| | - Cesare Gagliardo
- BiND Department: Biomedicine, Neuroscience and Advanced Diagnostic, University of Palermo, Via Del Vespro, 129 90127, Palermo, Italy
| | - Adele Taibbi
- BiND Department: Biomedicine, Neuroscience and Advanced Diagnostic, University of Palermo, Via Del Vespro, 129 90127, Palermo, Italy
| |
Collapse
|
34
|
Application of new ultrasound techniques for focal liver lesions. J Med Ultrason (2001) 2020; 47:215-237. [PMID: 31950396 DOI: 10.1007/s10396-019-01001-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 11/26/2019] [Indexed: 02/07/2023]
Abstract
Ultrasonography (US) has the overwhelming advantages of not entailing radiation exposure and being a noninvasive, real-time, convenient, easy-to-perform, and relatively inexpensive imaging modality. It is used as the first-line imaging modality for screening, detection, and diagnosis of focal liver lesions (FLLs) [small hepatocellular carcinomas (HCCs), in particular]. However, with the increasing demand for accurate and early diagnosis of small HCCs, newer radiologic methods need to be explored to overcome certain limitations of US. For example, the imaging is easily negatively affected by the presence of gas, rib cage, and subcutaneous fat, and is insensitive for capturing the subtle but vital information on the blood flow. It was in response to this need that new promising technologies such as contrast-enhanced ultrasound and fusion imaging were introduced for the detection of liver lesions. This paper presents an overview of the epidemiology and mechanisms of the development of HCCs, with an emphasis on the application of US in the diagnosis and treatment of FLLs. The aim of this article is to provide the state-of-the-art developments in the imaging diagnosis of FLLs and evaluation of ablation treatment of early HCCs. By keeping abreast of these recent advances, we hope that doctors and researchers working in the field of diagnosis/treatment of liver diseases will be able to discriminate benign FLLs such as regenerative nodules and focal nodular hyperplasia from HCCs, so as to avoid unnecessary repeated tumor biopsies and overtreatment. In particular, we expect that small HCCs or precancerous nodules (such as dysplastic nodules) can be accurately diagnosed and appropriately treated even at an early stage.
Collapse
|
35
|
|
36
|
Mohamed TMD, Ji-Bin LMD, John REP. Recent Advances in Microbubble-Augmented Cancer Therapy. ADVANCED ULTRASOUND IN DIAGNOSIS AND THERAPY 2020. [DOI: 10.37015/audt.2020.200055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
|
37
|
Sparchez Z, Mocan T, Hagiu C, Kacso G, Zaharie T, Rusu I, Al Hajjar N, Leucuta DC, Sparchez M. Real-Time Contrast-Enhanced-Guided Biopsy Compared with Conventional Ultrasound-Guided Biopsy in the Diagnosis of Hepatic Tumors on a Background of Advanced Chronic Liver Disease: A Prospective, Randomized, Clinical Trial. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:2915-2924. [PMID: 31447237 DOI: 10.1016/j.ultrasmedbio.2019.07.678] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 07/22/2019] [Accepted: 07/24/2019] [Indexed: 06/10/2023]
Abstract
We aimed to compare contrast-enhanced-guided liver biopsy (CEUSLB) and ultrasound-guided liver biopsy (USLB) in the diagnosis of focal liver lesions (FLLs) developed on a background of advanced chronic liver disease (ACLD). Between 2011 and 2019, patients diagnosed with liver tumors on a background of ACLD were evaluated for inclusion in the study. Patients were randomly assigned to the CEUSLB or USLB group. In total, 144 patients were randomly assigned to either CEUSLB (n = 79) or USLB (n = 65). Overall, in the CEUSLB group, the sensitivity was significantly better (94.74% vs. 74.6%, respectively; p = 0.001). Both the fragment length of the biopsy specimen and the single puncture success rate were statistically higher in the CEUSLB group (p = 0.022 and p = 0.0006, respectively). There was no difference in terms of major or minor complications (p = 0.682). CEUSLB is a feasible technique that increases the diagnostic sensitivity for liver tumors developed in ACLD.
Collapse
Affiliation(s)
- Zeno Sparchez
- 3rd Medical Department, Institute for Gastroenterology and Hepatology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Tudor Mocan
- 3rd Medical Department, Institute for Gastroenterology and Hepatology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
| | - Claudia Hagiu
- 3rd Medical Department, Institute for Gastroenterology and Hepatology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Gabriel Kacso
- Department of Medical Oncology and Radiotherapy, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Toader Zaharie
- 3rd Pathology Department, Institute for Gastroenterology and Hepatology, Cluj-Napoca, Romania
| | - Ioana Rusu
- 3rd Pathology Department, Institute for Gastroenterology and Hepatology, Cluj-Napoca, Romania
| | - Nadim Al Hajjar
- 3rd Surgical Department, Institute for Gastroenterology and Hepatology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Daniel Corneliu Leucuta
- Medical Informatics and Biostatistics Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mihaela Sparchez
- Iuliu Hatieganu University of Medicine and Pharmacy, 2nd Paediatric Clinic, Children's Hospital at Cluj-Napoca, Cluj-Napoca, Romania
| |
Collapse
|
38
|
Camacho JC, Petre EN, Sofocleous CT. Thermal Ablation of Metastatic Colon Cancer to the Liver. Semin Intervent Radiol 2019; 36:310-318. [PMID: 31680722 DOI: 10.1055/s-0039-1698754] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Colorectal cancer (CRC) is responsible for approximately 10% of cancer-related deaths in the Western world. Liver metastases are frequently seen at the time of diagnosis and throughout the course of the disease. Surgical resection is often considered as it provides long-term survival; however, few patients are candidates for resection. Percutaneous ablative therapies are also used in the management of this patient population. Different thermal ablation (TA) technologies are available including radiofrequency ablation, microwave ablation (MWA), laser, and cryoablation. There is growing evidence about the role of interventional oncology and image-guided percutaneous ablation in the management of metastatic colorectal liver disease. This article aims to outline the technical considerations, outcomes, and rational of TA in the management of patients with CRC liver metastases, focusing on the emerging role of MWA.
Collapse
Affiliation(s)
- Juan C Camacho
- Department of Radiology, Weill-Cornell Medical College, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Elena N Petre
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Constantinos T Sofocleous
- Department of Radiology, Weill-Cornell Medical College, Memorial Sloan Kettering Cancer Center, New York, New York
| |
Collapse
|
39
|
Maiettini D, Mauri G, Varano G, Bonomo G, Della Vigna P, Rebonato A, Orsi F. Pancreatic ablation: minimally invasive treatment options. Int J Hyperthermia 2019; 36:53-58. [DOI: 10.1080/02656736.2019.1647354] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Daniele Maiettini
- Division of Interventional Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Giovanni Mauri
- Division of Interventional Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Gianluca Varano
- Division of Interventional Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Guido Bonomo
- Division of Interventional Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Paolo Della Vigna
- Division of Interventional Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Alberto Rebonato
- Department of Radiology, AO Ospedali Riuniti Marche Nord, Pesaro, Italy
| | - Franco Orsi
- Division of Interventional Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| |
Collapse
|
40
|
Abstract
OBJECTIVE. The purpose of this study was to evaluate the efficacy of radiofrequency ablation (RFA) of renal masses comparing a group who did not undergo intraprocedural CT and a group who did. MATERIALS AND METHODS. A retrospective review included 45 consecutively registered patients who underwent RFA of renal masses. If an adequate biopsy specimen was not obtained or follow-up was inadequate, the patient was eliminated from review from calculation of primary technical efficacy. The inclusion criterion was having undergone RFA with two cooled-tip electrodes. Baseline demographics (age, body mass index, and sex), renal mass characteristics (diameter, side, location, position, morphologic features, type of mass, and grade), technical details (repositioning and hydrodissection), and complications were evaluated. Follow-up images were evaluated to determine the presence of recurrence at the ablation site in the two groups. RESULTS. Among the 45 patients who underwent RFA, 13 did not undergo intraprocedural CT and 32 intraprocedural did. Thirty-five patients met the criteria for follow-up and positive biopsy results. For calculation of recurrence, 10 patients were in the group who did not and 25 were in group who did undergo intraprocedural contrast-enhanced CT. No correlation was found between baseline demographics, renal mass characteristics, and technical results of the two groups. There was an 89% overall technical efficacy rate with a 96% primary technical efficacy rate in the group who underwent intraprocedural CT compared with a 70% rate in the group who did not undergo intraprocedural CT. Negative correlation was found between the groups with respect to technical efficacy rate at p < 0.05. CONCLUSION. Intraprocedural contrast-enhanced CT yields important information about completeness of ablation during the procedure, allowing probe repositioning and thus better therapeutic effect.
Collapse
|
41
|
Rodgers SK. Invited Commentary on "Contrast-enhanced US in Local Ablative Therapy and Secondary Surveillance for Hepatocellular Carcinoma," with Author Response. Radiographics 2019; 39:1322-1324. [PMID: 31364947 DOI: 10.1148/rg.2019190049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Shuchi K Rodgers
- Department of Radiology, Einstein Medical Center Philadelphia, Pennsylvania
| |
Collapse
|
42
|
Bansal S, Gui J, Merrill C, Wong JK, Burak KW, Wilson SR. Contrast-enhanced US in Local Ablative Therapy and Secondary Surveillance for Hepatocellular Carcinoma. Radiographics 2019; 39:1302-1322. [PMID: 31348734 DOI: 10.1148/rg.2019180205] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Hepatocellular carcinoma (HCC) has a high incidence of recurrence following therapy. Therefore, secondary surveillance (scheduled follow-up imaging after treatment) is an important part of disease management. The recent approval in the United States for use of a microbubble-based contrast agent for US liver imaging promotes the increased use of contrast-enhanced US (CEUS) in patients with HCC. Although the criteria for the diagnosis of HCC at CEUS are well described, there is a paucity of published literature describing the role of CEUS in ablative therapy and secondary surveillance. In the setting of ablative therapy, CEUS can have vital roles, including patient selection, intraprocedural guidance, and immediate postprocedural assessment. Although CEUS is not widely used, the authors found that it can be used to accurately detect residual or recurrent tumor, characterize the geographic pattern of recurrence (intrazonal, extrazonal, segmental, or remote), and assess for tumor in vein. In addition, similar to primary surveillance, secondary surveillance includes assessment of the entire liver for evaluation of new nodules. Arterial phase hyperenhancement is the reference standard characteristic of disease recurrence at secondary surveillance with CEUS. ©RSNA, 2019 See discussion on this article by Rodgers.
Collapse
Affiliation(s)
- Sanjay Bansal
- From the Department of Diagnostic Imaging, Foothills Medical Centre, 1403 29 St NW, Calgary, AB, Canada T2N 2T9 (S.B., J.G., C.M., J.K.W., S.R.W.); and Departments of Medicine, Division of Gastroenterology and Hepatology (K.W.B., S.R.W.), and Radiology (J.K.W., S.R.W.), University of Calgary, Calgary, Alberta, Canada
| | - Jonathan Gui
- From the Department of Diagnostic Imaging, Foothills Medical Centre, 1403 29 St NW, Calgary, AB, Canada T2N 2T9 (S.B., J.G., C.M., J.K.W., S.R.W.); and Departments of Medicine, Division of Gastroenterology and Hepatology (K.W.B., S.R.W.), and Radiology (J.K.W., S.R.W.), University of Calgary, Calgary, Alberta, Canada
| | - Christina Merrill
- From the Department of Diagnostic Imaging, Foothills Medical Centre, 1403 29 St NW, Calgary, AB, Canada T2N 2T9 (S.B., J.G., C.M., J.K.W., S.R.W.); and Departments of Medicine, Division of Gastroenterology and Hepatology (K.W.B., S.R.W.), and Radiology (J.K.W., S.R.W.), University of Calgary, Calgary, Alberta, Canada
| | - Jason K Wong
- From the Department of Diagnostic Imaging, Foothills Medical Centre, 1403 29 St NW, Calgary, AB, Canada T2N 2T9 (S.B., J.G., C.M., J.K.W., S.R.W.); and Departments of Medicine, Division of Gastroenterology and Hepatology (K.W.B., S.R.W.), and Radiology (J.K.W., S.R.W.), University of Calgary, Calgary, Alberta, Canada
| | - Kelly W Burak
- From the Department of Diagnostic Imaging, Foothills Medical Centre, 1403 29 St NW, Calgary, AB, Canada T2N 2T9 (S.B., J.G., C.M., J.K.W., S.R.W.); and Departments of Medicine, Division of Gastroenterology and Hepatology (K.W.B., S.R.W.), and Radiology (J.K.W., S.R.W.), University of Calgary, Calgary, Alberta, Canada
| | - Stephanie R Wilson
- From the Department of Diagnostic Imaging, Foothills Medical Centre, 1403 29 St NW, Calgary, AB, Canada T2N 2T9 (S.B., J.G., C.M., J.K.W., S.R.W.); and Departments of Medicine, Division of Gastroenterology and Hepatology (K.W.B., S.R.W.), and Radiology (J.K.W., S.R.W.), University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
43
|
Ma QP, Xu EJ, Zeng QJ, Su ZZ, Tan L, Chen JX, Zheng RQ, Li K. Intraprocedural computed tomography/magnetic resonance-contrast-enhanced ultrasound fusion imaging improved thermal ablation effect of hepatocellular carcinoma: Comparison with conventional ultrasound. Hepatol Res 2019; 49:799-809. [PMID: 30907477 DOI: 10.1111/hepr.13336] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 02/24/2019] [Accepted: 03/16/2019] [Indexed: 12/13/2022]
Abstract
AIM To retrospectively compare the treatment effect of intraprocedural computed tomography/magnetic resonance-contrast-enhanced ultrasound (CT/MR-CEUS) fusion imaging (FI) with that of conventional ultrasound (US) in the guidance and assessment of thermal ablation of hepatocellular carcinoma (HCC). METHODS The FI group (112 patients with 129 HCC) was treated between April 2010 and December 2012, whereas the US group (83 patients with 90 HCC) was treated between January 2008 and March 2010. Either CT/MR-CEUS FI or US was used to guide puncture, provide immediate assessment, and guide supplementary ablation. Technical efficacy, cumulative local tumor progression rate (LTP), recurrence-free survival (RFS), and overall survival (OS) were evaluated and compared during follow-up. Technical success rate of CT/MR-CEUS FI was also recorded. RESULTS Technical efficacy was significantly higher in the FI group than in the US group (100% vs. 86.7%, P < 0.001). The 1-, 2-, 3-, 4-, 5-, and 6-year cumulative LTP rates in the FI group were significantly lower than in the US group (3.8%, 4.9%, 6.0%, 6.0%, 7.2%, and 7.2% vs. 16.9%, 20.1%, 25%, 25%, 25%, and 25%, respectively; P < 0.001); RFS and OS were significantly higher in the FI group than in the US group (P = 0.027 and P = 0.049, respectively). The technical success rate of FI was 85.3%. CONCLUSIONS Intraprocedural CT/MR-CEUS FI improved the treatment effect of thermal ablation of HCC by immediately assessing treatment response and guiding supplementary ablation relative to those resulting from the use of conventional US.
Collapse
Affiliation(s)
- Qiu-Ping Ma
- Department of Ultrasound, Guangdong Key Laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Er-Jiao Xu
- Department of Ultrasound, Guangdong Key Laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Qing-Jing Zeng
- Department of Ultrasound, Guangdong Key Laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhong-Zhen Su
- Department of Ultrasound, Guangdong Key Laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Lei Tan
- Department of Ultrasound, Guangdong Key Laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jia-Xin Chen
- Department of Ultrasound, Guangdong Key Laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Rong-Qin Zheng
- Department of Ultrasound, Guangdong Key Laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Kai Li
- Department of Ultrasound, Guangdong Key Laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
44
|
De Angelis C, Vigna PD, Varano GM, Mauri G. Laser thermal ablation to treat a recurrent soft-tissue sarcoma of the leg: a case report. Ecancermedicalscience 2019; 13:908. [PMID: 31123491 PMCID: PMC6445535 DOI: 10.3332/ecancer.2019.908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Indexed: 12/03/2022] Open
Abstract
We present the case of a 52-year-old male patient with recurrence of a soft-tissue sarcoma of the left leg treated with percutaneous laser ablation. The patient received the diagnosis of sarcoma for the first time in 2011; further local recurrences and a pulmonary metastatic spread occurred during follow-up, so the patient has been treated several times with chemotherapy, limb-sparing surgery and radiotherapy. In September 2017, a new local recurrence of sarcoma occurred, for which limb amputation was proposed but refused by the patient. Laser ablation with ultrasound guidance was performed, with complete ablation at 6 months and limb salvage.
Collapse
Affiliation(s)
- Chiara De Angelis
- Division of Radiology, IEO, European Institute of Oncology IRCCS, via Ripamonti 435, 20141 Milan, Italy
| | - Paolo Della Vigna
- Division of Interventional Radiology, IEO, European Institute of Oncology IRCCS, via Ripamonti 435, 20141 Milan, Italy
| | - Gianluca Maria Varano
- Division of Interventional Radiology, IEO, European Institute of Oncology IRCCS, via Ripamonti 435, 20141 Milan, Italy
| | - Giovanni Mauri
- Division of Interventional Radiology, IEO, European Institute of Oncology IRCCS, via Ripamonti 435, 20141 Milan, Italy
| |
Collapse
|
45
|
Zhang W, Jin ZQ, Baikpour M, Li JM, Zhang H, Liang T, Pan XM, He W. Clinical application of ultrasound-guided percutaneous microwave ablation for benign breast lesions: a prospective study. BMC Cancer 2019; 19:345. [PMID: 30975107 PMCID: PMC6458746 DOI: 10.1186/s12885-019-5523-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 03/25/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Background: Benign breast lesions are the most common diseases in adult women, which have been treated with minimally invasive therapies in recent years. Little is known about the feasibility of Microwave ablation (MWA) for benign breast lesion treatment. The primary aim of this prospective study was to evaluate the safety and efficiency of MWA as a potential therapeutic option for benign breast lesions in a single-center cohort study. METHODS Women with possibly benign breast lesions based on an ultrasound (US) assessment who were scheduled to undergo MWA between November 2014 to July 2018 were included in the study. The patients underwent conventional US to measure the size of the lesion, Doppler US to assess the vascularity of the lesion, elastography to evaluate the stiffness of the mass, core needle biopsy of suspicious lesions, contrast-enhanced US to help determine the treatment plan and eventually MWA of the lesion. Lesions were followed at one, three, six, twelve and eighteen months after treatment to with the same imaging modalities. RESULTS A total of 314 women aged 17 to 69 years old (mean = 36.9 ± 9.9 years) with 725 benign breast lesions (mean of maximum diameter = 10.86 ± 5.40 mm) were included. The frequency of palpable mass, pain and nipple discharge significantly decreased after treatment. Complete ablation rate was 97.8%, immediately after ablation, which increased to 100% after supplementary ablation of the 15 cases with incomplete ablation. Blood flow classification and lesion's volume also showed a significant decrease, while both volume reduction ratio and disappearance rate significantly increased following treatment. The elasticity score of the lesions showed fluctuations across different follow-up intervals. None of the patients experienced major complications and the 1% who had mild symptoms were successfully treated. CONCLUSION MWA treatment is shown to be safe and efficient and has the potential to be considered as an alternative first line treatment for benign breast lesions.
Collapse
Affiliation(s)
- Wei Zhang
- Department of Ultrasound, Beijing Tian Tan Hospital, Capital Medical University, No. 119, West Road of South 4th Ring Road, Fengtai District, Beijing, 100160, China
| | - Zhan-Qiang Jin
- Department of Ultrasound, Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Masoud Baikpour
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Jian-Min Li
- Department of Ultrasound, The 3rd Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Hui Zhang
- Department of Thyroid and Breast Surgery, The 3rd Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Ting Liang
- Department of Ultrasound, The 3rd Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiao-Ming Pan
- Department of Thyroid and Breast Surgery, The 3rd Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Wen He
- Department of Ultrasound, Beijing Tian Tan Hospital, Capital Medical University, No. 119, West Road of South 4th Ring Road, Fengtai District, Beijing, 100160, China.
| |
Collapse
|
46
|
Monsky W, Keravnou C, Averkiou M. Contrast-enhanced ultrasound to ultrasound fusion during microwave ablation: feasibility study in a perfused porcine liver model. J Ultrasound 2019; 22:323-335. [PMID: 30811016 DOI: 10.1007/s40477-019-00366-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 02/21/2019] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To obtain a complete response with thermal ablation, the margin and entire tumor volume must be treated. Real-time ultrasound visualization is limited during ablation due to gas production. This study assesses the feasibility of fusing volumetric contrast-enhanced ultrasound (CEUS), obtained immediately prior to microwave ablation, with real-time CEUS during and following ablation in a machine-perfused porcine liver. METHODS Ten, 3-4 cm microwave ablations were performed in five explanted perfused livers. Prior to ablation, microbubbles were injected into the vasculature while an ultrasound sweep across the liver captured a volumetric image during maximum enhancement. This volumetric image was then fused to overlay the real-time ultrasound imaging. Since the perfused livers did not have tumors, a spherical marker circumscribing a target volume was placed on the images. Approximatively, 75% of the total intended circumscribed spherical volume was ablated. Following ablation, a second bolus injection of ultrasound contrast was administered demonstrating continued enhancement of the intentionally non-ablated 25%. A second volumetric image of the post-ablation CEUS was then fused to overlay the real-time ultrasound images for guidance during ablation of the remaining enhancing volume. RESULTS Technical success was achieved in 100% of the cases. The pre- and then the post-ablation CEUS volume was fused with real-time imaging during antenna placement for initial and subsequent ablation. CONCLUSION CEUS-CEUS fusion during thermal ablation is feasible and greatly improves the workflow. The approach may augment the use of dynamic CEUS for guidance, improving antenna placement, and aiding in the identification and ablation of initial and residual enhancing tissue.
Collapse
Affiliation(s)
- Wayne Monsky
- Division of Interventional Radiology, Department of Radiology, University of Washington Medical Center, 1959 NE Pacific St., Box 357115, Seattle, WA, USA.
| | - Christina Keravnou
- Department of Bioengineering, University of Washington, Seattle, WA, 98195, USA
| | - Michalakis Averkiou
- Department of Bioengineering, University of Washington, Seattle, WA, 98195, USA
| |
Collapse
|
47
|
Fusion Imaging and Virtual Navigation to Guide Percutaneous Thermal Ablation of Hepatocellular Carcinoma: A Review of the Literature. Cardiovasc Intervent Radiol 2019; 42:639-647. [PMID: 30809699 DOI: 10.1007/s00270-019-02167-z] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 01/14/2019] [Indexed: 12/12/2022]
|
48
|
Solbiati M, Muglia R, Goldberg SN, Ierace T, Rotilio A, Passera KM, Marre I, Solbiati L. A novel software platform for volumetric assessment of ablation completeness. Int J Hyperthermia 2019; 36:337-343. [PMID: 30729818 DOI: 10.1080/02656736.2019.1569267] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
| | - Riccardo Muglia
- Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy
| | - S. Nahum Goldberg
- Department of Radiology, Hadassah Hebrew University Medical Centre, Jerusalem, Israel
- Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Tiziana Ierace
- Department of Radiology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | | | | | | | - Luigi Solbiati
- Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy
- Department of Radiology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| |
Collapse
|
49
|
D'Onofrio M, Beleù A, De Robertis R. Ultrasound-guided percutaneous procedures in pancreatic diseases: new techniques and applications. Eur Radiol Exp 2019; 3:2. [PMID: 30671676 PMCID: PMC6342746 DOI: 10.1186/s41747-018-0081-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 12/14/2018] [Indexed: 02/08/2023] Open
Abstract
Ultrasound (US) is not only an important diagnostic tool for the evaluation of the pancreas, but is also a fundamental imaging technique to guide percutaneous interventions for several pancreatic diseases (fluid aspiration and drainage; invasive diagnosis by means fine-needle aspiration and core-needle biopsy; tumour ablation by radiofrequency, microwaves, irreversible electroporation, cryoablation, and high-intensity focused US). Technical improvements, such as contrast media and fusion imaging, have recently increased precision and safety and reduced procedure-related complications. New treatment US techniques for the ablation of pancreatic tumours, such as contrast-enhanced US and multimodality fusion imaging, have been recently developed and have elicited a growing interest worldwide. The purpose of this article was to review the most up-to-date role of US in percutaneous procedures for pancreatic diseases.
Collapse
Affiliation(s)
- Mirko D'Onofrio
- Department of Radiology, G.B. Rossi Hospital - University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Alessandro Beleù
- Department of Radiology, G.B. Rossi Hospital - University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy.
| | - Riccardo De Robertis
- PhD Programme in Inflammation, Immunity and Cancer, University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| |
Collapse
|
50
|
Yang G, Fang J, Yu T, Zhang Y, Zhang W, Zhao D, Xu J, Wang C. Percutaneous ultrasound-guided laser ablation for the treatment of cervical tuberculous lymphadenitis: a pilot study. J Int Med Res 2019; 47:1512-1520. [PMID: 30632441 PMCID: PMC6460608 DOI: 10.1177/0300060518821818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE This study was performed to assess the feasibility, effectiveness, and safety of percutaneous ultrasound (US)-guided laser ablation (LA) for the treatment of cervical tuberculous lymphadenitis (CTBL). METHODS We retrospectively reviewed 11 patients with CTBL (mean age, 32.0 ± 8.6 years; range, 18-47 years) who underwent percutaneous US-guided LA from June 2014 to December 2016 with a subsequent 12-month follow-up. We assessed the mean volume reduction and contrast-enhanced US (CEUS) changes of the target lymph nodes as well as the tolerability and adverse effects of LA. RESULTS The mean ablation energy was 522 ± 312 J (range, 204-1317 J). All 17 enrolled target lymph nodes were completely non-enhanced after LA treatment as detected by CEUS, indicating complete ablation of all lymph nodes (100%). The target lymph nodes significantly decreased in volume by a mean of 74.0% ± 15.6% from baseline to 12 months after LA. The LA procedure was well tolerated, and none of the 11 patients developed severe complications during the 12-month follow-up. CONCLUSION Percutaneous US-guided LA for the treatment of CTBL exhibits good tolerability, minimal invasiveness, and few adverse effects. Further investigations with larger sample sizes and longer follow-up periods are warranted to confirm these findings.
Collapse
Affiliation(s)
- Gaoyi Yang
- 1 Department of Ultrasonography, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, P.R. China
| | - Jianhua Fang
- 2 Department of Ultrasonography, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, P.R. China
| | - Tianzhuo Yu
- 1 Department of Ultrasonography, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, P.R. China
| | - Ying Zhang
- 1 Department of Ultrasonography, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, P.R. China
| | - Wenzhi Zhang
- 1 Department of Ultrasonography, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, P.R. China
| | - Dan Zhao
- 1 Department of Ultrasonography, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, P.R. China
| | - Jianping Xu
- 1 Department of Ultrasonography, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, P.R. China
| | - Caifen Wang
- 1 Department of Ultrasonography, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, P.R. China
| |
Collapse
|