Efficacy of Contrast-Enhanced US versus CT or MRI for the Therapeutic Control of Percutaneous Radiofrequency Ablation in the Case of Hepatic Malignancies

Zusammenfassung

Ziel: Zur Beurteilung der Aussagekraft kontrastmittelunterstützter Verfahren nach Radiofrequenzablationen (RFA) wurden Patienten mit malignen Lebertumoren nach RFA mit kontrastmittelverstärktem Ultraschall (CEUS), Computertomografie (CT) und Magnetresonanztomografie (MRI) verlaufskontrolliert und die Ergebnisse miteinander verglichen. Material und Methoden: Analysiert wurden über einen Zeitraum von 7 Jahren 194 RFAs von 76 Patienten mit 118 Raumforderungen der Leber (n = 55 HCC, n = 63 Metastasen), die mit Bildgebung (CEUS und CT/MRI) im Verlauf (Goldstandard zur Diagnosestellung) untersucht wurden. Kriterien für ein Rezidiv waren eine KM-Anreicherung im Bereich der behandelten Raumforderung von mehr als 5 mm und Größenwachstum von mind. 25 % im Follow-up. Ergebnisse: Vergleichsgruppe CEUS-CT: Von insgesamt 65 Vergleichsuntersuchungen stimmten die Befunde in 54 Fällen (83,1 %) überein. In 7 Fällen (10,8 %) wurde die korrekte Diagnose nur im CEUS gestellt, in 2 Fällen (3,1 %) nur im CECT. In 2 Fällen (3,1 %) lieferten beide Verfahren falsche Ergebnisse. Korrektklassifikationsrate (DA): CEUS 93,8 %, CT 86,2 %. Vergleichsgruppe CEUS-MRI: Von insgesamt 26 Vergleichsuntersuchungen stimmten CEUS und MRI in 23 Fällen bzw. 88,5 % überein. In den 3 diskordanten Fällen (11,5 %) wurde die korrekte Diagnose nur im CEUS gestellt. DA (n = 26): CEUS 100 %, MRI 88,4 %. Schlussfolgerung: Im Follow-up von Tumorbehandlungen der Leber ist CEUS der CT und der MRI ebenbürtig.

Abstract

Purpose: The goal of this study was to assess the informative value of contrast-enhanced ultrasound after radiofrequency ablation (RFA). Patients who had undergone RFA of malignant liver tumors were followed up with contrast-enhanced sonography (CEUS), computed tomography (CT) and/or magnetic resonance tomography (MRI), and the outcomes were compared. Materials and Methods: 76 patients undergoing 194 RFAs for 118 hepatic neoplasms (n = 55 HCC, n = 63 metastases) in the course of a 7-year period were examined post-interventionally using CEUS and CT or MRI. During follow-up (gold standard of evaluation), contrast agent rim accumulations with a diameter greater than 5 mm and a growth rate of at least 25 % were counted as a recurrence. Results: CEUS-CT comparison group: A total of 65 scan pairs were compared. In 54 cases (83.1 %) the findings were the same with either method. In 7 cases (10.8 %) CEUS confirmed the correct diagnosis, and in 2 cases (3.1 %) only CT was correct. In 2 cases (3.1 %) both methods yielded incorrect results. Diagnostic accuracy (DA): CEUS 93.8 %, CT 86.2 %. CEUS-MRI comparison group: In 23 cases (88.5 %) of a total of 26 scan pairs, the findings were the same for both CEUS and MRI. In 3 discordant cases only CEUS confirmed the correct diagnosis (3 cases, 11.5 %). Diagnostic accuracy DA (n = 26): CEUS 100 %, MRI 88.4 %. Conclusion: CEUS performs equally to CT and MRI in the follow-up of patients treated for liver tumors by RFA.

Key words

abdomen - ablation procedures - contrast agents

References

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