Radiofrequency ablation of hepatocellular carcinoma: predicting success using contrast-enhanced sonography

AJR. American Journal of Roentgenology
Marcus J Dill-MackyStephanie Wilson

Abstract

This pilot study compared the utility of immediate postprocedural contrast-enhanced sonography with that of delayed enhanced sonography and CT or MRI in assessing the success of radiofrequency ablation of hepatocellular carcinoma. Twenty-two lesions (1.5-3.7 cm) were studied in 19 patients. Enhanced sonography was performed before and within 1 hr after radiofrequency ablation. At routine 2-week follow-up CT or MRI, additional enhanced sonography was performed. The findings of preablation CT or MRI and enhanced sonography were compared with those of postprocedural and follow-up enhanced sonography by three radiologists experienced in these techniques. The reviewers were unaware of the follow-up CT or MRI results (reference standard). Technical adequacy, ablation zone targeting, and identification of residual disease were assessed by each reviewer, and the results were analyzed by consensus. One postprocedural sonographic study was considered technically inadequate. Postprocedural sonography predicted the follow-up CT or MRI results in 76% (16/21) of subjects (sensitivity, 88%; specificity, 40%; positive predictive value [PPV], 82%; negative predictive value, [NPV] 50%). Follow-up CT or MRI identified accurate targeting in 17 of ...Continue Reading

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