Luciano Tarantino MD, Presenter: Nothing to Disclose

Antonio Giorgio MD, Abstract Co-Author: Nothing to Disclose

Paolo Sorrentino, Abstract Co-Author: Nothing to Disclose

Giorgio de Stefano MD, Abstract Co-Author: Nothing to Disclose

Antonella Di Sarno, Abstract Co-Author: Nothing to Disclose

Giovanna Ferraioli MD, Abstract Co-Author: Nothing to Disclose

Triphasic contrast-enhanced helical CT (CT) is the standard technique for the assessment of results of Percutaneous Ablation Therapies (PATs). The aim of our study was to compare the diagnostic accuracy of Contrast Enhanced Ultrasound (CEUS) and CT in the assessment of short-term results of Hepatocellular Carcinoma (HCC) ablation.

Fifty-six consecutive cirrhotic patients with a single biopsy proven HCC’s nodule (diameter, 1.8 – 5.0 cm; mean, 3.2 cm) underwent PATs. CT and CEUS were performed in all patients within 7 days before treatment, and within 14 and 21 days after treatment. CEUS was performed at low mechanical index after IV administration of a second generation contrast agent (BR1, SonoVueTM, Bracco, Milan, Italy).Patients with post-treatment residual tumor underwent further PATs. Patients with complete necrosis at CT and/or CEUS were followed-up with US every two months and CT every 12 months. In case US or CT showed local recurrence, CT, CEUS and one or more FNB of the suspected lesions were performed.

Post-treatment CT and CEUS showed complete necrosis in 45/56 (80%) and 42/56 nodules (75%) respectively. 3 nodules that were necrotic at CT and partially necrotic at CEUS relapsed at 2, 4, and 4 months follow-up. During the follow-up (6 – 20 months; mean, 11.9 months) 8 patients with post-treatment complete necrosis relapsed within 4 – 18 months. FNB proved presence of HCC in all recurrences. Diagnostic accuracy of CT and CEUS was 85.7% and 83.3% respectively; the difference was not statistically significant.

In the assessment of necrosis of treated lesions, diagnostic accuracy of CEUS is similar to that of CT. CEUS could reliably be used to assess the local efficacy of PAT of HCC.

Tarantino, L, Giorgio, A, Sorrentino, P, de Stefano, G, Di Sarno, A, Ferraioli, G, Triphasic Helical CT and Real-Time Contrast-enhanced US in the Assessment of Efficacy of Percutaneous Ablation of Hepatocellular Carcinoma.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4409268.html