Hamid Reza Sadeghi Neshat MSc, Presenter: Nothing to Disclose

Rohit Joshi MD,BEng, Abstract Co-Author: Nothing to Disclose

Derek William Cool MD, PhD, Abstract Co-Author: Nothing to Disclose

Cesare Romagnoli MD, Abstract Co-Author: Nothing to Disclose

Amol Mujoomdar MD, Abstract Co-Author: Nothing to Disclose

Aaron Fenster PhD, Abstract Co-Author: Nothing to Disclose

Nirmal Kakani MD, Abstract Co-Author: Nothing to Disclose

Microwave tumor ablation is emerging as a common thermal treatment of hepatocellular carcinoma (HCC) due to its higher treatment temperatures, shorter ablation times and relatively painless procedure. Limitations of this procedure are its high recurrence rates and relatively small ablation zone with a single antenna insertion. An array with multiple antennas is used to achieve larger ablation zones. However, accurate placement of the probes is essential in achieving optimal treatment. The location of the needles, not only with respect to each other but also within the tumor is difficult to achieve using conventional two-dimensional (2D) intra-operative ultrasound (US). Also, the close proximity of the probes increases the risk of complications, such as skin burn, and limits its use.

Five patients who under went routine ablation for HCC were included. Initial assessment of the lesion included a pre procedural 3D ultrasound and determining a predicted ablation zone and needle placement. Using 5 MHz transducer, with a tilt-mechanical translator developed in our laboratory, multiple 3D US scans were acquired pre-operatively, and following the insertion of each additional antenna to ensure the appropriate placement. Routine ablation was then carried out, however the 3D ultrasound was again used to assess the needle placements in the tumour. A third set of images were then obtained following the ablation with and with out ultrasound contrast. All sets of images were then compared to establish an immediate ablation zone.

We present our initial experience in using three-dimensional (3D) US with real-time volume reconstructions, to accurately predict ablation zones prior to the procedure. The predicted ablation were comparable to the post procedural zones assessed with 3D contrast ultrasound.

Utilizing 3D US to predict ablation patterns, and utilising this information to more accurately place the needles with in a tumour helps achieve a uniform ablation zone. Further trials are being undertaken to confirm our initial findings.

Utilization of 3D ultrasound to predict ablation patterns in liver tumours

Sadeghi Neshat, H, Joshi, R, Cool, D, Romagnoli, C, Mujoomdar, A, Fenster, A, Kakani, N, Increasing Uniformity of Ablation Zone in the Liver Using 3D Ultrasound.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11034605.html