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- Title
Improvement of ablative margins by the intraoperative use of CEUS-CT/MR image fusion in hepatocellular carcinoma.
- Authors
Kai Li; Zhong-Zhen Su; Er-Jiao Xu; Jin-Xiu Ju; Xiao-Chun Meng; Rong-Qin Zheng; Li, Kai; Su, Zhong-Zhen; Xu, Er-Jiao; Ju, Jin-Xiu; Meng, Xiao-Chun; Zheng, Rong-Qin
- Abstract
<bold>Background: </bold>To assess whether intraoperative use of contrast-enhanced ultrasound (CEUS)-CT/MR image fusion can accurately evaluate ablative margin (AM) and guide supplementary ablation to improve AM after hepatocellular carcinoma (HCC) ablation. <bold>Methods: </bold>Ninety-eight patients with 126 HCCs designated to undergo thermal ablation treatment were enrolled in this prospective study. CEUS-CT/MR image fusion was performed intraoperatively to evaluate whether 5-mm AM was covered by the ablative area. If possible, supplementary ablation was applied at the site of inadequate AM. The CEUS image quality, the time used for CEUS-CT/MR image fusion and the success rate of image fusion were recorded. Local tumor progression (LTP) was observed during follow-up. Clinical factors including AM were examined to identify risk factors for LTP. <bold>Results: </bold>The success rate of image fusion was 96.2% (126/131), and the duration required for image fusion was 4.9 ± 2.0 (3-13) min. The CEUS image quality was good in 36.1% (53/147) and medium in 63.9% (94/147) of the cases. By supplementary ablation, 21.8% (12/55) of lesions with inadequate AMs became adequate AMs. During follow-up, there were 5 LTPs in lesions with inadequate AMs and 1 LTP in lesions with adequate AMs. Multivariate analysis showed that AM was the only independent risk factor for LTP (hazard ratio, 9.167; 95% confidence interval, 1.070-78.571; p = 0.043). <bold>Conclusion: </bold>CEUS-CT/MR image fusion is feasible for intraoperative use and can serve as an accurate method to evaluate AMs and guide supplementary ablation to lower inadequate AMs.
- Subjects
LIVER cancer; ABLATIVE materials; CONTRAST-enhanced ultrasound; INTRAOPERATIVE monitoring; IMAGE fusion; CANCER tomography; MAGNETIC resonance imaging of cancer; TUMOR treatment; CATHETER ablation; COMPARATIVE studies; COMPUTED tomography; HEPATOCELLULAR carcinoma; LIVER tumors; RESEARCH methodology; MEDICAL cooperation; RESEARCH; ULTRASONIC imaging; THREE-dimensional imaging; EVALUATION research; CONTRAST media; DRUG administration; DRUG dosage; THERAPEUTICS
- Publication
BMC Cancer, 2016, Vol 16, p1
- ISSN
1471-2407
- Publication type
journal article
- DOI
10.1186/s12885-016-2306-1