Irreversible electroporation in patients with liver tumours: treated-area patterns with contrast-enhanced ultrasound
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(2020) 18:305
RESEARCH
Open Access
Irreversible electroporation in patients with liver tumours: treated-area patterns with contrast-enhanced ultrasound Linyu Zhou1, Shanyu Yin1, Weilu Chai1, Qiyu Zhao2, Guo Tian3, Danxia Xu1 and Tian’an Jiang1,2*
Abstract Background: Familiarity with post-IRE imaging interpretation is of considerable importance in determining ablation success and detecting recurrence. CEUS can be used to assess the tumour response and characteristics of the ablation zone. It is of clinical interest to describe the ultrasonographic findings of liver tumours after irreversible electroporation (IRE) percutaneous ablation. Methods: A prospective study of 24 cases of malignant liver tumours (22 cases of primary liver tumours and 2 cases of liver metastases) treated by IRE ablation was conducted. Two inspectors evaluated the ablation zone in a consensus reading performed immediately, 1 day, and 1 month after IRE ablation. The gold standard method, magnetic resonance imaging (MRI), was used to evaluate the effectiveness of the treatment at 1 month. Results: Immediately after IRE ablation and up to 1 month later, the ablation zones gradually changed from hypoechogenicity to hyper-echogenicity on conventional ultrasound and showed non-enhancement on contrastenhanced ultrasound (CEUS). One month after IRE ablation, CEUS and MRI results were highly consistent (κ = 0.78, p < 0.05). Conclusions: We conclude that CEUS may be an effective tool for assessing post-IRE ablation changes after 1 month. CEUS enables the depiction of tumour vascularity in real time and serves as an easy, repeatable method. Keywords: Irreversible electroporation, Liver tumours, Contrast-enhanced ultrasound, Ablation, Ultrasonography
Introduction Liver cancer is the fourth leading cause of cancer-related deaths in the world [1]. Most patients are not eligible for radical surgical resection at the time of diagnosis. Radiofrequency ablation (RFA), microwave ablation (MWA) or cryoablation is potentially curative in select patients. * Correspondence: [email protected] The study was conducted at the Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University 1 Department of Ultrasonography, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, P.R. China 2 Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, P.R. China Full list of author information is available at the end of the article
However, the efficacy of ablation is limited by the size, number and location of the lesion. As a result, the effectiveness and safety of these techniques are limited for lesions adjacent to important structures, such as the bile duct, portal vein, and gastrointestinal tract. For patients with such lesions, irreversible electroporation (IRE) is considered an alternative treatment. C
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