scholarly journals Evaluation of Contrast-Enhanced Intraoperative Ultrasound in the Detection and Management of Liver Lesions in Patients with Hepatocellular Carcinoma

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Cristina Pace ◽  
Vittorio Nardone ◽  
Silvia Roma ◽  
Fabrizio Chegai ◽  
Luca Toti ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Intraoperative Ultrasound ◽  
Preoperative Imaging ◽  
Liver Lesions ◽  
Therapy Decision ◽  
Contrast Enhanced ◽  
Regenerative Nodules ◽  
Malignant Liver

Aim. To evaluate the role of contrast-enhanced intraoperative ultrasound (CE-IOUS) during liver surgery in the detection and management of liver lesions in patients with hepatocellular carcinoma (HCC). Materials and Methods. From December 2016 to December 2017, 50 patients with HCC, who were candidates for liver resection, were evaluated with intraoperative ultrasound (IOUS). For all patients, MRI and/or CT were performed before surgery. During surgery, IOUS was performed after liver mobilization, and when nodules that had not been detected in the preoperative MRI and/or CT were observed, CE-IOUS scans were carried out with the dual purpose of better characterizing the unknown lesion and discovering new lesions. Results. In 12 patients, IOUS showed 14 nodules not detected by preoperative MRI and/or CT, before surgery. Out of the 12 lesions, five presented vascular features compatible with those of malignant HCC to the evaluation with CE-IOUS and four of these were simultaneously treated with intraoperative radiofrequency ablation (RFA). The fifth lesion was resected by the surgeon. The remaining nine lesions recognized by IOUS were evaluated as benign at CE-IOUS and considered regenerative nodules. The last diagnosis was confirmed during follow-up obtained by means of CT and/or MRI after 1, 3, 6, or 12 months. Conclusion. In our experience, CE-IOUS is a useful diagnostic tool in both benign pathologies, such as regenerative nodules, and malignant liver lesions. The advantage of this approach is the possibility of intraoperatively characterizing, based on vascularization patterns, lesions that could not be diagnosed by preoperative imaging, resulting in modification of the surgical therapy decision and expansion of the resection or intraoperative ablation.

scholarly journals Endoscopic Ultrasound for Detection of Liver Metastasis: Hope or Hype?

2021 ◽  
Author(s):  
Anupam Kumar Singh ◽  
Surinder S. Rana
Keyword(s):  
Endoscopic Ultrasound ◽  
Imaging Modality ◽  
Intraoperative Ultrasound ◽  
Liver Lesions ◽  
Contrast Enhanced ◽  
Magnetic Resonance Imaging Mri ◽  
Hepatic Lesions ◽  
Enhanced Computed Tomography ◽  
Metastatic Liver

AbstractTransabdominal ultrasonography, contrast-enhanced computed tomography, and magnetic resonance imaging (MRI) are the common diagnostic tests for the detection of hepatic lesions. Use of enhanced and advanced MRI technique, that is, diffusion weighted MRI and hepatocyte-specific contrast agents, has further improved the accuracy of detection of metastatic liver lesions ≤10 mm in diameter. However, even with these advanced imaging modalities sensitivity is low for lesions smaller than 10 mm when compared with standard intraoperative ultrasound. Endoscopic ultrasound (EUS) is an emerging imaging modality with resolution sufficient to detect and sample lesions as small as 5 mm in diameter. In this news and views, we have discussed the role of standard and enhanced EUS for the detection of metastatic liver lesions.

scholarly journals Laparoscopic Contrast-Enhanced Ultrasonography for Real Time Monitoring of Laparoscopic Radiofrequency Ablation for Hepatocellular Carcinoma: an Observational Pilot Study

2019 ◽  
Vol 28 (4) ◽  
pp. 457-462
Author(s):  
Adrian Bartoș ◽  
Dana Bartos ◽  
Zeno Spârchez ◽  
Ioana Iancu ◽  
Lidia Ciobanu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Real Time ◽  
Intraoperative Ultrasound ◽  
Percutaneous Ablation ◽  
Real Time Monitoring ◽  
Neoplastic Tissue ◽  
Laparoscopic Radiofrequency Ablation ◽  
Contrast Enhanced ◽  
Internally Cooled

Background and Aims: Laparoscopic radio-frequency ablation (L-RFA) for hepatocellular carcinoma (HCC) is used for unresectable tumors, with difficult location, unfitted for a percutaneous ablation technique. L-RFA has a high incidence of local recurrence. Even if intraoperative-ultrasound is standardized for staging and RFA probe guidance, the role of laparoscopic contrast-enhanced ultrasound (L-CEUS) for the real time monitoring of L-RFA efficacy has not been previously reported. We evaluated in a pilot observational study the efficacy of L-CEUS to assess the necrotic post-ablative area in difficult to treat HCC. Methods: Eight consecutive patients diagnosed with HCC (peripherally located) on liver cirrhosis were referred for L-RFA between May 2016 and December 2018. For L-RFA a SturBurst XL (AngioDinamics®) internally cooled electrode was used, being placed under ultrasound guidance. L-CEUS was used to assess the necrotic post-ablative area. The median follow up period was 18 months. Results: L-CEUS real time monitoring of the L-RFA efficacy indicated residual neoplastic tissue in 4 cases (50%). The procedure was repeated by reinserting the needle in the suspected areas indicated by L-CEUS. Complete tumor ablation was achieved in all treated patients. After a median follow-up of 18 months no recurrence of HCC was observed in 7 patients (87.5%). Conclusions: L-CEUS was a reliable procedure for the immediate assessment of L-RFA efficacy; half of the ablated HCC nodules required a second ablation session. This approach might decrease the local recurrences, but its role must be further investigated in larger cohorts.

Role of CEUS in Vascular Pathology

2021 ◽  
Author(s):  
Vito Cantisani ◽  
Nicola Di Leo ◽  
Emanuele David ◽  
Dirk-André Clevert
Keyword(s):  
Research Field ◽  
Arterial System ◽  
Qualitative Assessment ◽  
Vascular Pathology ◽  
New Horizons ◽  
Contrast Enhanced ◽  
Inflammatory Infiltrates ◽  
Time Evaluation

AbstractIn recent years, the implementation of contrast-enhanced ultrasound (CEUS) in clinical practice has opened new horizons in the arterial pathologies research field, since this technique is able to supply new sets of data that can be crucial in patient management. The main applications of CEUS in the arterial system are the detection, characterization, and follow-up of carotid plaques and endoleaks after EVAR. Other situations in which CEUS was demonstrated to be a useful tool are large vessel vasculitis, dissections, and untreated aneurysms. In carotid atherosclerosis CEUS is not only able to acquire quantitative data about stenosis but also to perform a qualitative assessment of the plaque. The most important plaque features that CEUS is able to depict are ulceration, neovascularization, and the presence of inflammatory infiltrates. All of these factors contribute to plaque vulnerability. Thus, CEUS is crucial in order to allow better risk stratification and management of patients. In follow-up after EVAR, CEUS shows sensitivity and specificity values similar to CTA while ensuring several advantages, such as lower cost and the absence of ionizing radiation and nephrotoxic agents. Moreover, CEUS is able to offer real-time evaluation of endoleaks and thus is a useful tool in cases that are ambiguous on CTA. Most limitations are patient-related and are the same as in all other ultrasound techniques, such as high BMI and meteorism.

scholarly journals Incremental Role of 18F-FDG PET with contrast enhanced CT (PET-CECT) in detection of recurrence of carcinoma cervix

2016 ◽  
Author(s):  
S. Dash ◽  
A. Goel ◽  
S. Sogani
Keyword(s):  
Fdg Pet ◽  
Carcinoma Cervix ◽  
Histopathological Correlation ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Radiologic Imaging ◽  
18F Fdg

Purpose: To evaluate the role of 18F-FDG PET with contrast enhanced CT (PET-CECT) in early detection of recurrence in follow up patients of carcinoma cervix. Methods: Patients with histopathologically proven carcinoma cervix who underwent chemotherapy, radiotherapy and/or surgery and on follow up were recruited in the study. Fifty-two patients underwent 18F-FDG PET-CECT for detection of recurrence. The median age was 51.5 (average = 53.4) years. PET-CECT studies were evaluated and analyzed separately by an experienced nuclear medicine physician and a radiologist independently. The physicians were blinded for the patient history. PET-CECT results were validated with histopathological correlation, conventional radiologic imaging/follow up PET-CECT study and clinical follow up. Results: Out of 52 patients, 34 patients were reported as positive for recurrence, 17 of these were having active local recurrence and 31 patients had regional lymph nodal metastases, 14 patients had distant metastases (out of them 6 patients had distant lymph node metastases, 6 had pulmonary metastases, 4 had skeletal metastases and two had liver metastases). Remaining 18 patients were reported as negative for recurrence. The lung was the most common site for distant metastasis. Patient were then further evaluated based on histopathological correlation, conventional radiologic imaging and follow up PET-CECT scan and five were found to be false positive and one patient was identified as false negative. The sensitivity, specificity, positive and negative predictive value were derived to be 96.7%, 77.3%, 85.3% and 94.4%, respectively. Accuracy was calculated to be 88.5%. Conclusions: 18F-FDG PET-CECT is a very useful non-invasive modality for the early detection of recurrence and metastatic workup in patients with carcinoma cervix with a very high sensitivity and negative predictive value. It is also useful in targeting biopsy sites in suspected cases of recurrence.

scholarly journals Use of Contrast-Enhanced Ultrasound with Sonazoid for Evaluating the Radiotherapy Efficacy for Hepatocellular Carcinoma

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 486
Author(s):  
Akihiro Funaoka ◽  
Kazushi Numata ◽  
Atsuya Takeda ◽  
Yusuke Saigusa ◽  
Yuichirou Tsurugai ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Retrospective Study ◽  
Local Recurrence ◽  
Tumor Size ◽  
Size Reduction ◽  
Contrast Enhanced Ultrasound ◽  
Tumor Vascularity ◽  
Contrast Enhanced

Radiotherapy is one of the available curative therapies for hepatocellular carcinoma (HCC). We investigate the use of contrast-enhanced ultrasound using Sonazoid (SCEUS) in evaluating the efficacy of radiotherapy for HCC. We enrolled 59 patients with 59 HCCs in this retrospective study. Tumor size and tumor vascularity were evaluated using SCEUS before and 1, 3, 7, 10, and 13 months after radiotherapy. The median follow-up period was 44.5 months (range: 16–82 months). Of the HCCs, 95% (56/59) had no local recurrence, while 5% (3/59) did. At 13 months after radiotherapy, in cases with no local recurrence, SCEUS showed a reduction in tumor vascularity in all cases, while tumor size reduction (>30% reduction, compared with pre-radiotherapy) was observed in 82.1% (46/56). In all three cases of local recurrence, vascularity and tumor size reduction were not observed during the follow-up period and residual HCCs were demonstrated pathologically. Compared with cases with local recurrence, tumor size reduction and reduction in tumor vascularity (p < 0.001) were significantly greater in cases with no local recurrence at 13 months after radiotherapy. SCEUS may be useful in evaluating radiotherapy efficacy for HCC.

Contrast-enhanced ultrasound of malignant liver lesions

2017 ◽  
Vol 43 (4) ◽  
pp. 819-847 ◽  
Author(s):  
Isabelle Durot ◽  
Stephanie R. Wilson ◽  
Jürgen K. Willmann
Keyword(s):  
Liver Lesions ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced ◽  
Malignant Liver ◽  
Malignant Liver Lesions

Differential diagnosis of focal liver lesions: role of spin-echo and contrast-enhanced dynamic MR imaging.

Radiology ◽  
1994 ◽  
Vol 193 (1) ◽  
pp. 59-65 ◽  
Author(s):  
Y Yamashita ◽  
Y Hatanaka ◽  
H Yamamoto ◽  
A Arakawa ◽  
T Matsukawa ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Mr Imaging ◽  
Spin Echo ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Dynamic Mr Imaging ◽  
Contrast Enhanced ◽  
Dynamic Mr

Intraoperative high resolution linear contrast enhanced ultrasound (IOUS) for detection of microvascularization of malignant liver lesions before surgery or radiofrequeny ablation

2012 ◽  
Vol 50 (1-2) ◽  
pp. 65-77 ◽  
Author(s):  
Martin Loss ◽  
Julia Schneider ◽  
Wibke Uller ◽  
P. Wiggermann ◽  
Marcus N. Scherer ◽  
...  
Keyword(s):  
High Resolution ◽  
Liver Lesions ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced ◽  
Linear Contrast ◽  
Malignant Liver ◽  
Malignant Liver Lesions

scholarly journals Role of contrast-enhanced ultrasound in the evaluation of vascularization of hepatocellular carcinoma

2016 ◽  
Vol 2 (11) ◽  
Author(s):  
Francesco Loria ◽  
Giuseppe Loria ◽  
Salvatore Basile ◽  
Giuseppe Crea ◽  
Luciano Frosina ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced
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