Comparison of real-time contrast-enhanced ultrasonography and standard ultrasonography in liver cancer microwave ablation

Abstract

Primary liver cancer has a high incidence and high mortality rates, and currently the only viable option is surgery, although there are a number of difficulties related to this method. The aim of the present study was to investigate the potential advantages of the real-time contrast-enhanced ultrasonography (CEUS) for microwave ablation of primary liver cancer. One hundred patients with primary liver cancer were included in the study. The patients were divided into the ordinary ultrasonography and the CEUS groups. For the ordinary ultrasonography group, the ordinary ultrasonography-guided microwave ablation method was used, while microwave ablation under the guidance of CEUS was conducted for the CEUS group. The size of lesions and clearness of the tumor boundary prior to surgery in the two groups were compared. Additionally, postoperative complications and the survival rate were monitored. Lesion boundary areas measured by CEUS were significantly larger than those measured with ordinary ultrasonography. The incidence rate of postoperative pain, fever, intra-abdominal hemorrhage and infection and other complications in the ordinary ultrasonography group were significantly higher than that in the CEUS group. The tumor recurrence rate in the CEUS group was significantly lower than that in the ordinary ultrasonography group. Seventy-two percent of patients in the CEUS group showed no progress, compared to 48% of in the ordinary ultrasonography group. The progress-free survival rate in the CEUS group after 6 months was significantly higher than that in the ordinary ultrasonography group. Disease-free survival time in the CEUS group was considerably longer than the control group. In conclusion, the guidance of real-time CEUS on the primary liver cancer microwave ablation treatment can achieve good intra-operative results. It offers a real-time guidance effect, improves survival time and reduces the incidence of complications.

Optimized Echo Decorrelation Imaging Feedback for Bulk Ultrasound Ablation Control

“…Ultrasound imaging has advantages of being portable and inexpensive, while its high frame rate is suitable for real-time monitoring of moving organs like the liver [14]. Recent research efforts have used real-time US image fusion [20] with MRI or CT images, as well as contrast-enhanced US (CEUS) imaging [21], aid tumor margin visualization during treatment planning and assessment. However, the ability of B-mode US to predict the extent of thermal ablation is limited by the formation of heat-induced microbubble clouds (hyperechoic activity), causing acoustic shadowing and making tumor boundaries difficult to visualize [22].…”

Contrast-Enhanced Ultrasound for Guidance of Percutaneous Liver Interventions in Neoplastic Hepatic Disease

“…This study also demonstrated decreased postprocedural pain, fever, intra-abdominal hemorrhage, infection, and other complications in comparison to the standard US group. 36 Further studies showed that CEUS has comparable efficacy to CTor MRI with regard to the treatment response assessment following MWA of liver lesions. 37,38 Two institutional representative CEUS-guided MWA cases of malignant liver lesions are presented in ►Figs.…”

The Application of Laparoscopic B-Ultrasound Microwave Ablation Technology in Liver Metastasis of Colorectal Cancer

“…In terms of improving the accuracy of liver metastases under laparoscope, surgeons and ultrasound doctors have also conducted various studies. Yan Shi Yan et al [22] compared the treatment of real-time contrast-enhanced ultrasound with that of standard ultrasound, and the real-time contrast-enhanced ultrasound under laparoscope is more accurate in positioning liver lesions. There are also some scholars who use MRI [23], PET-MRI [24], robot guided [25] to locate the focus for treatment, but the clinical application is not extensive.…”