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Role of contrast-enhanced ultrasound in evaluating the efficiency of ultrasound guided percutaneous microwave ablation in patients with renal cell carcinoma.

Li X, Liang P, Yu J, Yu XL, Liu FY, Cheng ZG, Han ZY - Radiol Oncol (2013)

Bottom Line: The CEUS results of the third day after the ablation were compared with the synchronous contrast-enhanced computed tomography (CT)/magnetic resonance imaging (MRI) results and biopsy pathological results.The combination of clinical follow-up results and CT/MRI imaging findings was the reference standard of CEUS results for evaluating the therapeutic effect.Among residual tumours, 13 (86.7%) were confirmed by contrast-enhanced CT/MRI findings and biopsy results.

View Article: PubMed Central - PubMed

Affiliation: Interventional Ultrasound Department of Chinese PLA General Hospital, Beijing, China ; Medical College of Nankai University, Tianjin, China.

ABSTRACT

Background: The aim of the study was to evaluate the efficiency and feasibility of contrast-enhanced ultrasound (CEUS) with Sonovue in assessing of renal cell carcinomas (RCCs) following ultrasound (US)-guided percutaneous microwave ablation (MWA).

Patinets and methods: Seventy-nine patients (60 males and 19 females) with 83 lesions (mean size 3.2±1.6 cm) were treated by US-guided percutaneous MWA. The CEUS results of the third day after the ablation were compared with the synchronous contrast-enhanced computed tomography (CT)/magnetic resonance imaging (MRI) results and biopsy pathological results. The follow-up was performed by CEUS and CT/MRI after 1, 3, 6 months and every 6 months subsequently. The combination of clinical follow-up results and CT/MRI imaging findings was the reference standard of CEUS results for evaluating the therapeutic effect. The identification of residual or recurrence tumour was assessed by two blinded radiologists.

Results: On the third day after MWA, CEUS showed 68 of 83 lesions (68/83, 81.9%) successfully ablated and 15 of 83 (18.1%) with residual tumours. Among residual tumours, 13 (86.7%) were confirmed by contrast-enhanced CT/MRI findings and biopsy results. The sensitivity, specificity, accuracy, positive and negative predictive value of CEUS evaluating the short-term MWA effectiveness were 100%, 97.1%, 97.6%, 86.7% and 100%, respectively. During the six years follow-up (median 26 months), the CEUS showed recurrence in 7 patients, and six of them achieved consistent results on CEUS and CT/MRI imaging. The sensitivity, specificity, accuracy, positive and negative predictive value for CEUS evaluating long-term MWA effectiveness were 85.7%, 98.7%, 97.6%, 85.7% and 98.7%, respectively.

Conclusions: The post-procedural CEUS demonstrated as an effective and feasible method in evaluating a therapeutic effect of RCCs following MWA.

No MeSH data available.


Related in: MedlinePlus

Pre-ablation contrast-enhanced US showed a 4.7 cm × 3.9 cm exophyticly renal papillary cell carcinoma heterogeneous hyper-enhancement with no-enhancement zone in a 56-year-old woman (A, arrow), and 1 month after ablation contrast-enhancement US showed an hyper-enhancement area in cortical phase which was diagnosed as abnormal perfusion (B, red arrow), while the corresponding period CT and MRI showed the hyper-enhancement in article phase and diagnosed as a recurrence tumour (C, D, red arrow). Then the patient received biopsy and another ablation and verified the recurrence.
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f4-rado-47-04-398: Pre-ablation contrast-enhanced US showed a 4.7 cm × 3.9 cm exophyticly renal papillary cell carcinoma heterogeneous hyper-enhancement with no-enhancement zone in a 56-year-old woman (A, arrow), and 1 month after ablation contrast-enhancement US showed an hyper-enhancement area in cortical phase which was diagnosed as abnormal perfusion (B, red arrow), while the corresponding period CT and MRI showed the hyper-enhancement in article phase and diagnosed as a recurrence tumour (C, D, red arrow). Then the patient received biopsy and another ablation and verified the recurrence.

Mentions: During the median follow-up period of 26 months (rang 3–74 months), seventy-six patients survived and three patients died of heart failure, gastrorrhagia and multiple organs failure at 37, 39, 61 months after the ablation respectively. Seventy-six (76/83) lesions showed a completed ablation during the follow-up (Figure 3). Seven (7/83) lesions were detected recurrent tumour, confirmed by CEUS and CT/MRI in six patients with consistency. One patient with the lesion (max diameter 4.7 cm, located exophytic and adjacent to intestinal tract) showed a completed ablation at 6 months after the ablation on CEUS, but local tumour progression was detected on MRI and then confirmed by subsequent nephrectomy (Figure 4). At 15 months after the ablation CEUS detected recurrence in one patient with max diameter 5.8 cm lesion located endophytic close to pelvis but the result was denied by MRI, while the CT imaging and biopsy result verified the result of CEUS and the CT and CEUS confirmed complete necrosis during 74 months follow-up. The sensitivity, specificity, accuracy, PPV and NPV for CEUS detecting residual or recurrence tumour during the follow-up period were 85.7%, 98.7%, 96.7 %, 85.7% and 98.7%, respectively (Table 3).


Role of contrast-enhanced ultrasound in evaluating the efficiency of ultrasound guided percutaneous microwave ablation in patients with renal cell carcinoma.

Li X, Liang P, Yu J, Yu XL, Liu FY, Cheng ZG, Han ZY - Radiol Oncol (2013)

Pre-ablation contrast-enhanced US showed a 4.7 cm × 3.9 cm exophyticly renal papillary cell carcinoma heterogeneous hyper-enhancement with no-enhancement zone in a 56-year-old woman (A, arrow), and 1 month after ablation contrast-enhancement US showed an hyper-enhancement area in cortical phase which was diagnosed as abnormal perfusion (B, red arrow), while the corresponding period CT and MRI showed the hyper-enhancement in article phase and diagnosed as a recurrence tumour (C, D, red arrow). Then the patient received biopsy and another ablation and verified the recurrence.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3814286&req=5

f4-rado-47-04-398: Pre-ablation contrast-enhanced US showed a 4.7 cm × 3.9 cm exophyticly renal papillary cell carcinoma heterogeneous hyper-enhancement with no-enhancement zone in a 56-year-old woman (A, arrow), and 1 month after ablation contrast-enhancement US showed an hyper-enhancement area in cortical phase which was diagnosed as abnormal perfusion (B, red arrow), while the corresponding period CT and MRI showed the hyper-enhancement in article phase and diagnosed as a recurrence tumour (C, D, red arrow). Then the patient received biopsy and another ablation and verified the recurrence.
Mentions: During the median follow-up period of 26 months (rang 3–74 months), seventy-six patients survived and three patients died of heart failure, gastrorrhagia and multiple organs failure at 37, 39, 61 months after the ablation respectively. Seventy-six (76/83) lesions showed a completed ablation during the follow-up (Figure 3). Seven (7/83) lesions were detected recurrent tumour, confirmed by CEUS and CT/MRI in six patients with consistency. One patient with the lesion (max diameter 4.7 cm, located exophytic and adjacent to intestinal tract) showed a completed ablation at 6 months after the ablation on CEUS, but local tumour progression was detected on MRI and then confirmed by subsequent nephrectomy (Figure 4). At 15 months after the ablation CEUS detected recurrence in one patient with max diameter 5.8 cm lesion located endophytic close to pelvis but the result was denied by MRI, while the CT imaging and biopsy result verified the result of CEUS and the CT and CEUS confirmed complete necrosis during 74 months follow-up. The sensitivity, specificity, accuracy, PPV and NPV for CEUS detecting residual or recurrence tumour during the follow-up period were 85.7%, 98.7%, 96.7 %, 85.7% and 98.7%, respectively (Table 3).

Bottom Line: The CEUS results of the third day after the ablation were compared with the synchronous contrast-enhanced computed tomography (CT)/magnetic resonance imaging (MRI) results and biopsy pathological results.The combination of clinical follow-up results and CT/MRI imaging findings was the reference standard of CEUS results for evaluating the therapeutic effect.Among residual tumours, 13 (86.7%) were confirmed by contrast-enhanced CT/MRI findings and biopsy results.

View Article: PubMed Central - PubMed

Affiliation: Interventional Ultrasound Department of Chinese PLA General Hospital, Beijing, China ; Medical College of Nankai University, Tianjin, China.

ABSTRACT

Background: The aim of the study was to evaluate the efficiency and feasibility of contrast-enhanced ultrasound (CEUS) with Sonovue in assessing of renal cell carcinomas (RCCs) following ultrasound (US)-guided percutaneous microwave ablation (MWA).

Patinets and methods: Seventy-nine patients (60 males and 19 females) with 83 lesions (mean size 3.2±1.6 cm) were treated by US-guided percutaneous MWA. The CEUS results of the third day after the ablation were compared with the synchronous contrast-enhanced computed tomography (CT)/magnetic resonance imaging (MRI) results and biopsy pathological results. The follow-up was performed by CEUS and CT/MRI after 1, 3, 6 months and every 6 months subsequently. The combination of clinical follow-up results and CT/MRI imaging findings was the reference standard of CEUS results for evaluating the therapeutic effect. The identification of residual or recurrence tumour was assessed by two blinded radiologists.

Results: On the third day after MWA, CEUS showed 68 of 83 lesions (68/83, 81.9%) successfully ablated and 15 of 83 (18.1%) with residual tumours. Among residual tumours, 13 (86.7%) were confirmed by contrast-enhanced CT/MRI findings and biopsy results. The sensitivity, specificity, accuracy, positive and negative predictive value of CEUS evaluating the short-term MWA effectiveness were 100%, 97.1%, 97.6%, 86.7% and 100%, respectively. During the six years follow-up (median 26 months), the CEUS showed recurrence in 7 patients, and six of them achieved consistent results on CEUS and CT/MRI imaging. The sensitivity, specificity, accuracy, positive and negative predictive value for CEUS evaluating long-term MWA effectiveness were 85.7%, 98.7%, 97.6%, 85.7% and 98.7%, respectively.

Conclusions: The post-procedural CEUS demonstrated as an effective and feasible method in evaluating a therapeutic effect of RCCs following MWA.

No MeSH data available.


Related in: MedlinePlus