Contrast enhanced ultrasound: Should it play a role in immediate evaluation of liver tumors following thermal ablation?

Meloni, Franca; Andreano, Anita; Franza, Elvira; Passamonti, Matteo; Lazzaroni, Sergio

doi:10.1016/j.ejrad.2012.05.002

Cited by 60 publications

(53 citation statements)

References 17 publications

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“…Unlike the resected specimen, the evaluation of the ablation zone and ablation margin is very challenging when determined by imaging alone. In addition to contrast-enhanced CT [65], ultrasonography [66] and magnetic resonance imaging [67] have been used to assess tumor margin and ablation completeness. Recently, positron emission tomography/computed tomography (PET/CT) guidance and immediate PET assessment of the tumor ablation procedure ( fig.…”

Section: Discussionmentioning

confidence: 99%

Thermal Ablation in the Management of Colorectal Cancer Patients with Oligometastatic Liver Disease

Petre

Sofocleous

2017

Visc Med

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Background: Surgical resection of limited colorectal liver disease improves long-term survival and can be curative in a subset of selected cases. Image-guided percutaneous ablation therapies have emerged as safe and effective alternative options for selected patients with unresectable colorectal liver metastases (CLM) that can be ablated with margins. Ablation causes focal destruction of tissue and has increasingly been shown to provide durable eradication of tumors. Methods: A selective review of literature was conducted in PubMed, focusing on recent studies reporting on the safety, efficacy, and long-term outcomes of percutaneous ablation modalities in the treatment of CLM. The present work gives an overview of the different ablation techniques, their current clinical indications, and reported outcomes from most recently published studies. The ‘test of time' concept for using ablation as a first local therapy is also described. Results: There are several thermal ablative tools currently available, including radiofrequency ablation (RFA), microwave ablation, and cryoablation. Most data to date originated from the application of RFA. Adjuvant thermal ablation in the treatment of oligometastatic colon cancer liver disease offers improved oncologic outcomes. The ideal CLM amenable to percutaneous ablation is a solitary tumor with the largest diameter up to 3 cm that can be completely ablated with a sufficient margin. 5-year overall survival rates up to 70% after ablation of unresectable CLM have been reported. Pathologic confirmation of complete tumor necrosis with margins over 5 mm provides best long-term local tumor control by thermal ablation. Conclusion: Current evidence suggests that percutaneous ablation as adjuvant to chemotherapy improves oncologic outcomes of patients with CLM. For small tumors that can be ablated completely with clear margins, percutaneous ablation may offer outcomes similar to those of surgery.

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Section: Discussionmentioning

confidence: 99%

Thermal Ablation in the Management of Colorectal Cancer Patients with Oligometastatic Liver Disease

Petre

Sofocleous

2017

Visc Med

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“…This can be especially helpful given that applicator placement is not confined to the axial plane. Ultrasound contrast agents can also be used to increase the conspicuity of the tumors during applicator placement and to assess for residual tumor immediately after ablation (53,54). Contrast-enhanced ultrasound imaging allows for vascular enhancement patterns to be evaluated in real-time.…”

Section: Current Techniques For Treating Liver Cancer Using Microwavementioning

confidence: 99%

Microwave ablation in primary and secondary liver tumours: technical and clinical approaches

Meloni¹,

Chiang

Laeseke

et al. 2016

International Journal of Hyperthermia

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Thermal ablation is increasingly utilized in the treatment of primary and metastatic liver tumors, both as curative therapy and as a bridge to transplantation. Recent advances in high-powered microwave ablation systems have allowed physicians to realize the theoretical heating advantages of microwave energy compared to other ablation modalities. As a result, there is a growing body of literature detailing the effects of microwave energy on tissue heating, as well as its effect on clinical outcomes. This article will discuss the relevant physics, review current clinical outcomes and then describe the current techniques used to optimize patient care when using microwave ablation systems.

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“…However, it might have some limitations in its application for the deep pancreatic carcinoma because of ultrasonic attenuation characteristics. MR elasticity imaging is of course a perfect image modality for assessing the ablation effect qualitatively because MRI has unique capabilities for planning, guiding, and monitoring ablation treatments due to its inherent soft tissue contrast and many specialized imaging sequences [29]. However, there was no report about its application in human beings and the cost is expensive.…”

Section: Discussionmentioning

confidence: 99%

Correlation between Ultrasound Reflection Intensity and Tumor Ablation Ratio of Late-Stage Pancreatic Carcinoma in HIFU Therapy: Dynamic Observation on Ultrasound Reflection Intensity

Miao

Wang

et al. 2013

The Scientific World Journal

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The minimally invasive high-intensity focused ultrasound (HIFU) therapy is thermal ablation treatment for late-stage pancreatic carcinoma with widely recognized safety and effectiveness, but there are currently no instant assessment methods for its ablation effect. It is vital to find a real-time high-sensitive assessment method. This research aims to dynamically observe the variation rules of ultrasound reflection intensity, analyze the correlation between ultrasound reflection intensity and tumor ablation ratio, and find out the value of ultrasound reflection intensity in prognosis of HIFU ablation effect. HIFU intermittent therapies were retrospectively analyzed for 31 subjects with late-stage pancreatic carcinoma from March 2007 to December 2009 in the study. The variation rules of the ultrasound reflection intensity during HIFU therapy were summarized and the correlation between ultrasound reflection intensity and tumor ablation ratio was analyzed based on the tumor ablation ratio indicated by CT scanning. The conclusion is that variation of ultrasound reflection intensity can be used for initial assessment of tumor ablation in HIFU therapy and early prognosis of overall HIFU ablation, providing important clinical basis for improving safety and effectiveness of HIFU therapy. Ultrasound can work as a real-time imaging instrument for observation of HIFU ablation effect in treating late-stage pancreatic carcinoma.

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Contrast enhanced ultrasound: Should it play a role in immediate evaluation of liver tumors following thermal ablation?

Cited by 60 publications

References 17 publications

Thermal Ablation in the Management of Colorectal Cancer Patients with Oligometastatic Liver Disease

Thermal Ablation in the Management of Colorectal Cancer Patients with Oligometastatic Liver Disease

Microwave ablation in primary and secondary liver tumours: technical and clinical approaches

Correlation between Ultrasound Reflection Intensity and Tumor Ablation Ratio of Late-Stage Pancreatic Carcinoma in HIFU Therapy: Dynamic Observation on Ultrasound Reflection Intensity

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