DIFFERENTIAL IMAGING OF LIVER TUMORS BEFORE AND AFTER MICROWAVE ABLATION WITH ELECTRODE DISPLACEMENT ELASTOGRAPHY

作     者：Pohlman, Robert M. Hinshaw, James L. Ziemlewicz, Timothy J. Lubner, Meghan G. Wells, Shane A. Lee, Fred T., Jr. Alexander, Marci L. Wergin, Kelly L. Varghese, Tomy 

作者机构：Univ Wisconsin Dept Elect & Comp Engn Madison WI 53706 USA Univ Wisconsin Dept Med Phys Sch Med & Publ Hlth Madison WI 53706 USA Univ Wisconsin Dept Radiol Sch Med & Publ Hlth Madison WI 53706 USA 

出 版 物：《ULTRASOUND IN MEDICINE AND BIOLOGY》 (超声在医学和生物学中的 应用)

年 卷 期：2021年第47卷第8期

页      面：2138-2156页

核心收录：

学科分类：1009[医学-特种医学] 0702[理学-物理学] 10[医学] 

基　　金：National Institutes of Health [2R01 CA112192  T32 CA009206] 

主　　题：Elastography Segmentation Treatment monitoring Liver cancer treatment Microwave ablation 

摘      要：Liver cancer is a leading cause of cancer-related deaths;however, primary treatment options such as surgical resection and liver transplant may not be viable for many patients. Minimally invasive image-guided microwave ablation (MWA) provides a locally effective treatment option for these patients with an impact comparable to that of surgery for both cancer-specific and overall survival. MWA efficacy is correlated with accurate image guidance;however, conventional modalities such as B-mode ultrasound and computed tomography have limitations. Alternatively, ultrasound elastography has been used to demarcate post-ablation zones, yet has limitations for pre-ablation visualization because of variability in strain contrast between cancer types. This study attempted to characterize both pre-ablation tumors and post-ablation zones using electrode displacement elastography (EDE) for 13 patients with hepatocellular carcinoma or liver metastasis. Typically, MWA ablation margins of 0.5-1.0 cm are desired, which are strongly correlated with treatment efficacy. Our results revealed an average estimated ablation margin inner quartile range of 0.54-1.21 cm with a median value of 0.84 cm. These treatment margins lie within or above the targeted ablative margin, indicating the potential to use EDE for differentiating index tumors and ablated zones during clinical ablations. We also obtained a high correlation between corresponding segmented cross-sectional areas from contrast-enhanced computed tomography, the current clinical gold standard, when compared with EDE strain images, with r(2) values of 0.97 and 0.98 for pre- and post-ablation regions. (C) 2021 World Federation for Ultrasound in Medicine & Biology. All rights reserved.