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(Radiology. 1999;211:643-649.)
© RSNA, 1999

Vascular and Interventional Radiology

Radio-frequency Ablation of Hepatic Metastases: Postprocedural Assessment with a US Microbubble Contrast Agent—Early Experience1

Luigi Solbiati, MD, S. Nahum Goldberg, MD, Tiziana Ierace, MD, Marina Dellanoce, MD, Tito Livraghi, MD and G. Scott Gazelle, MD, MPH

1 From the Department of Radiology, Ospedale Generale, Busto Arsizio (VA), Italy (L.S., T.I., M.D.); the Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston (S.N.G., G.S.G.); and the Department of Radiology, Ospedale Civile, Vimercate (MI), Italy (T.L.). Received March 20, 1998; revision requested April 27; revision received August 5; accepted November 5. Address reprint requests to G.S.G., MGH DATA Group, Zero Emerson Pl, Ste 2H, Boston, MA 02114.

PURPOSE: To evaluate contrast agent–enhanced ultrasonography (US) in the detection of untreated tumor after radio-frequency (RF) ablation of hepatic metastases.

MATERIALS AND METHODS: Twenty patients with solitary colorectal liver metastases underwent percutaneous RF tumor ablation. Pre- and postablation imaging was performed with nonenhanced and enhanced color and power Doppler US and contrast-enhanced helical computed tomography (CT). Initial follow-up CT and US were performed 24 hours after ablation. The findings at US and CT were compared.

RESULTS: Nonenhanced US demonstrated intratumoral signal in 15 of 20 metastases before ablation. This signal increased after contrast agent administration. Contrast-enhanced US performed 24 hours after ablation demonstrated residual foci of enhancement in three tumors, whereas no US signals were seen in any tumor on nonenhanced scans. CT demonstrated small (<3-mm) persistent foci of residual enhancement in these three tumors and in three additional lesions that were not seen at US (US sensitivity, 50%; specificity, 100%; diagnostic agreement with CT, 85%). All six patients with evidence of residual tumor underwent repeat RF ablation.

CONCLUSION: Contrast-enhanced US may depict residual tumor after RF application and thereby enable additional directed therapy. The potential reduction in treatment sessions and/or ancillary imaging procedures might increase the ease and practicality of percutaneous ablation of focal hepatic metastases.

Index terms: Liver neoplasms, secondary, 761.33 • Liver neoplasms, US, 761.12981, 761.12983, 761.12984, 761.12986, 761.12988 • Radiofrequency (RF) ablation • Ultrasound (US), contrast media, 761.12988 • Ultrasound (US), Doppler studies, 761.12983, 761.12984 • Ultrasound (US), power Doppler studies, 761.1299




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