3-D Contrast-Enhanced Ultrasound Fusion Imaging: A New Technique to Evaluate the Ablative Margin of Radiofrequency Ablation for Hepatocellular Carcinoma

Zhang, Xiaoer; Huang, Guangliang; Ye, Jieyi; Xu, Ming; Cong, Longfei; He, Xueling; Huang, Tzou‐Chi; Kuang, Ming; Xie, Xian-Jin

doi:10.1016/j.ultrasmedbio.2019.03.019

Cited by 8 publications

(14 citation statements)

References 29 publications

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“…Some previous studies also used preoperative and postoperative 3D CEUS to evaluate the ablation margin of HCC after thermal ablation (17,27). Similar to our study, Ye et al found that 3D CEUS fusion imaging enabled evaluation of the ablation margin of HCC immediately after radiofrequency ablation with an accuracy comparable to that of CT fusion imaging (17).…”

Section: Discussionsupporting

confidence: 85%

“…Compared with previous study, the technique presented in our study has several advantages. Firstly, in our study, the real visual 3D technology was used to view 3D CEUS fusion images, whereas previous studies displayed 3D CEUS slice-by-slice (27). In our study, we significantly improved the visualization of fusion images by using a 3D view of the tumor volume, safety margin volume, and ablation margin volume with different translucent colors, which can display the tumor, safety margin, and ablation margins in a relatively straightforward way.…”

Section: Discussionmentioning

confidence: 99%

“…Through this function, we were able to determine whether the lesion had been completely ablated, and whether the ablation area had reached the safety margin. Secondly, in previous studies (17,27), the ablation margin was measured on the 3D CEUS fusion images based on the shortest distance between the tumor margin and the ablation area. In our study, once the ablation area had been segmented, the residual ablation volume needed to achieve safety margin and the proportion of the residual ablation volume to the whole ablation volume could be calculated automatically.…”

Section: Discussionmentioning

confidence: 99%

“…With a higher mechanical index, the increased visibility could help the operator to find landmarks more easily. Furthermore, compared to previous studies using a matrix probe (17,27), we obtained the 3D images using the free-arm method, which can reduce the influence of the ribs and is suitable for larger tumors. The limitations of this study are as follows.…”

Section: Discussionmentioning

confidence: 99%

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A novel mono-modality fusion imaging method based on three-dimensional contrast-enhanced ultrasound for the evaluation of ablation margins after microwave ablation of hepatocellular carcinoma

Jing¹,

Wang²,

Zhou³

et al. 2021

J Gastrointest Oncol

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Background: To investigate the feasibility and accuracy of using preoperative and postoperative threedimensional contrast-enhanced ultrasound (3D CEUS) fusion imaging in the evaluation of safety margins after thermal ablation of hepatocellular carcinoma (HCC). Methods: A total of the 24 patients with HCC who underwent microwave ablation (MWA) between June 2020 and December 2020 were enrolled in this study. All patients received preoperative and postoperative 3D CEUS. The preoperative and postoperative 3D CEUS images were then fused. The success rate and evaluation time were recorded. The ablation margin and whether or not the safety margin was reached were calculated and recorded. If the ablation safety margin was not reached, the residual ablation volume needed to cover the safety margin was calculated automatically. The agreement between contrast-enhanced computed tomography(CECT) and 3D CEUS fusion imaging in the evaluation of ablation margins was explored using the kappa coefficient.Results: The 3D CEUS fusion success rate was 95.8% (23/24), with a mean fusion time of (4.1±1.8) minutes. Twenty-three tumors were completely ablated, and the safety margin was achieved for 9 tumors. The ablation margin of 14 tumors was <5 mm. The mean uncovered safety margin volume was (2.27±2.11) mL, and the mean proportion of the uncovered safety margin to the whole safety margin was 16.8%. According to the results of preoperative and postoperative CECT fusion imaging, the ablation margin of 13 tumors was <5 mm, and the ablation margin of 10 tumors was >5 mm. The 2 methods showed excellent consistency, with a Kappa value of 0.911 (P=0.000012). Conclusions: This study has presented a novel mono-modality fusion imaging method based on CEUS.We demonstrated that 3D CEUS fusion has a short fusion time and a high success rate, as well as good consistency with enhanced CT fusion. Therefore, 3D CEUS fusion is a feasible and accurate tool for evaluating the immediate efficacy of thermal ablation of HCC.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

A novel mono-modality fusion imaging method based on three-dimensional contrast-enhanced ultrasound for the evaluation of ablation margins after microwave ablation of hepatocellular carcinoma

Jing¹,

Wang²,

Zhou³

et al. 2021

J Gastrointest Oncol

View full text Add to dashboard Cite

show abstract

“…During CEUS, microbubble-specific software on the sonographic console weakens all background signal intensity so that the operator can clearly see the signal intensity produced by the contrast agent passing under the sonographic probe, while the nonvascularized (unenhanced) tissue remains invisible [ 17 ]. CEUS has been used to evaluate the ablation effect in many studies [ 18 , 19 ]. However, due to the presence of vaporization mass after ablation and the hyperemia reaction around the ablation zone, it is difficult to accurately determine the extent of the lesion and evaluate the ablation effect in the short-term after ablation using contrast-enhanced ultrasound.…”

Section: Discussionmentioning

confidence: 99%

Real-Time Elastography versus Shear Wave Elastography on Evaluating the Timely Radiofrequency Ablation Effect of Rabbit Liver: A Preliminary Experimental Study

Shi

Liao

et al. 2023

Diagnostics

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Purpose: to evaluate and monitor the timely thermal ablation changes of rabbit liver by using two elastographic methods—real-time elastography (RTE) and shear wave elastography (SWE)—as compared to contrast-enhanced ultrasound (CEUS) and physical specimens. Materials and Methods: 20 ablation zones were created in the livers of 20 rabbits using radiofrequency ablation (RFA). After the ablation, RTE and SWE were used to measure the elastic properties of the twenty ablation zones. The consistency of efficacy evaluation for RTE and SWE measurements was analyzed using the Bland–Altman test. The areas of the thermal ablation zones were also measured and compared according to the images provided by RTE, SWE, CEUS, and gross physical specimen measurement. Results: RTE and SWE could clearly display the shape of RFA ablation zones within one hour after the ablation. The average elasticity ratio for the ablation zone measured by RTE was 3.41 ± 0.67 (2.23–4.76); the average elasticity value measured by SWE was 50.7 ± 11.3 kPa (33.2–70.4 kPa). The mean areas of the ablation zones measured with RTE, SWE, gross specimen, and CEUS were 1.089 ± 0.199 cm2, 1.059 ± 0.201 cm2, 1.081 ± 0.201 cm2, and 3.091 ± 0.591 cm2, respectively. The Bland–Altman test showed that RTE and SWE have great consistency. Area measurements by CEUS were significantly larger than those of the other three methods (p < 0.05). Conclusion: RTE and SWE are both able to accurately confirm the range of ablation zones shortly after the ablation for rabbit livers.

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Efficacy of fusion imaging for immediate post‐ablation assessment of malignant liver neoplasms: A systematic review

Rai,

Ansari,

Warfa

et al. 2023

Cancer Medicine

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Background: Percutaneous thermal ablation has become the preferred therapeutic treatment option for liver cancers that cannot be resected. Since ablative zone tissue changes over time, it becomes challenging to determine therapy effectiveness over an extended period. Thus, an immediate post-procedural evaluation of the ablation zone is crucial, as it could influence the need for a second-look treatment or follow-up plan. Assessing treatment response immediately after ablation is essential to attain favorable outcomes. This study examines the efficacy of image fusion strategies immediately post-ablation in liver neoplasms to determine therapeutic response.Methodology: A comprehensive systematic search using PRISMA methodology was conducted using EMBASE, MEDLINE (via PUBMED), and Cochrane Library Central Registry electronic databases to identify articles that assessed the immediate post-ablation response in malignant hepatic tumors with fusion imaging (FI) systems. The data were retrieved on relevant clinical characteristics, including population demographics, pre-intervention clinical history, lesion characteristics, and intervention type. For the outcome metrics, variables such as average fusion time, intervention metrics, technical success rate, ablative safety margin, supplementary ablation rate, technical efficacy rate, LTP rates, and reported complications were extracted.Results: Twenty-two studies were included for review after fulfilling the study eligibility criteria. FI's immediate technical success rate ranged from 81.3% to 100% in 17/22 studies. In 16/22 studies, the ablative safety margin was assessed immediately after ablation. Supplementary ablation was performed in 9 studies following immediate evaluation by FI. In 15/22 studies, the technical effectiveness rates during the first follow-up varied from 89.3% to 100%.

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3-D Contrast-Enhanced Ultrasound Fusion Imaging: A New Technique to Evaluate the Ablative Margin of Radiofrequency Ablation for Hepatocellular Carcinoma

Cited by 8 publications

References 29 publications

A novel mono-modality fusion imaging method based on three-dimensional contrast-enhanced ultrasound for the evaluation of ablation margins after microwave ablation of hepatocellular carcinoma

A novel mono-modality fusion imaging method based on three-dimensional contrast-enhanced ultrasound for the evaluation of ablation margins after microwave ablation of hepatocellular carcinoma

Real-Time Elastography versus Shear Wave Elastography on Evaluating the Timely Radiofrequency Ablation Effect of Rabbit Liver: A Preliminary Experimental Study

Efficacy of fusion imaging for immediate post‐ablation assessment of malignant liver neoplasms: A systematic review

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