Ultrasound evaluation of efficacy of radiofrequency thermal ablation in the treatment of hepatic carcinoma / 中国微创外科杂志

ABSTRACT

Objective To discuss the value of ultrasonography in the evaluation of efficacy of radiofrequency (RF) thermal ablation for hepatic carcinoma. Methods A total of 49 patients with 66 lesions of hepatic carcinoma underwent ultrasound-guided multipolar radiofrequency ablation. Ultrasound examinations were carried out on tumor sizes, echo signals, vascular flows and frequency spectrums before and after the treatment. Moreover, AFP or CEA levels before and after the procedure were observed. And the CT scanning results were regarded as the control. Results Ultrasound examinations 1 month after the ablation found that “claw-like” heterogeneous hyperechoic changes covered the whole tumors without vascular flows inside in 42 patients with 59 lesions (89 4%). Afterwards, the tumors gradually reduced or remained unchanged in size, with a homogeneous echo texture. The serum levels of AFP or CEA markedly reduced or dropped down to normal. All of these were suggestive of an excellent curative effect. In the remaining 7 patients with 7 lesions (10 6%), intratumoral echo pattern kept unchanged, with arterial flow signals inside and unremarkable decrease of AFP or CEA levels, all of which were suggestive of an unsatisfactory outcome of the first radiofrequency treatment and a requirement of an additional radiofrequency treatment. CT examinations 1 month after the ablation revealed an enhancement of lesions in 9 patients with 9 lesions, among which the CT results were in agreement with the ultrasound outcomes in 7 patients with 7 lesions. Compared with the enhanced CT scans, ultrasonography in the detection of intratumoral vascular flows had a sensitivity of 55 6% (5/9), a specificity of 96 5% (55/57) and an accuracy of 90 9% (60/66). Conclusions Ultrasonography is an effective alternative for the evaluation of efficacy of radiofrequency thermal ablation in the treatment of hepatic carcinoma.