Edward Lam-Shang Leen MD, Presenter: Nothing to Disclose

Susan Moug, Abstract Co-Author: Nothing to Disclose

Jenny Logue MBCHB, Abstract Co-Author: Nothing to Disclose

Jenny Darrien MBCHB, Abstract Co-Author: Nothing to Disclose

Wilson Angerson PhD, Abstract Co-Author: Nothing to Disclose

Paul Horgan MD, Abstract Co-Author: Nothing to Disclose

To assess the value of CE-US in the staging and guidance of RFA of focal liver tumours

Based on CT/MRI findings, 91 consecutive patients (45 with metastases; 46 with hepatocellular carcinomas) with 177 lesions referred for RFA under ultrasound (US) guidance were studied. Prior to RFA, staging with US on fundamental/harmonic modes followed by CE-US (SonoVue doses: 2.4 – 4.8ml) with non-linear imaging modes at low mechanical index was performed. The number of lesions identified on US and CE-US were mapped and counted to match those identified on CT/MR. The number of lesions successfully targeted by CE-US as confirmed on follow-up CT/MR was counted.

The sensitivity of US in the detection of metastases, hepatocellular carcinomas and all lesions combined was 42.9%, 66.7% and 51.4% respectively; in comparison, the sensitivity for CE-US was significantly higher (100%) for all 3 groups (p<0.0001, p<0.03, and p<0.05 respectively). Complete US guided RFA would have been impossible without the use of SonoVue in 55 patients (60.4%) as the lesions remained occult on unenhanced US and of these, no lesions could be detected in 14 patients (15.4%). To identify all lesions as seen on CT/MRI, CE-US was required in 88.9% patients with metastases compared with 41.3% of patients with hepatocellular carcinomas. 44.4% of the patients with metastases had been on chemotherapy and all required CE-US to detect all lesions. No patient was subsequently referred for CT/MRI guided RFA. Follow-up CT/MRI confirmed successful targeting in all patients.

CE-US is an essential tool in the staging and guidance of US guided RF Ablation of focal liver lesions

Leen, E, Moug, S, Logue, J, Darrien, J, Angerson, W, Horgan, P, Value of Contrast-enhanced Ultrasound (CE-US) in the Radiofrequency Ablation (RFA) of Focal Liver Tumours: Is It Needed?.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4409813.html