IDDF2021-ABS-0030 4D ultrasonography for therapeutic radiofrequency ablation for hepatocellular carcinoma-included enhanced-ultrasonography

• Published in: Gut Vol. 70; no. Suppl 2; pp. A67 - A68
• Main Author: Hotta, Naoki
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.09.2021
• Subjects: Angiography; Computed tomography; Hepatocellular carcinoma; Liver cancer; Nodules; Patients; Perfusion; Radiofrequency ablation; Ultrasonic imaging; United States > US
• ISSN: 0017-5749; 1468-3288
• DOI: 10.1136/gutjnl-2021-IDDF.65

BackgroundStudies to evaluate the tumor vascularity in HCC have been done extensively with various imaging modalities because the fiding of the vascularity is helpful to evaluate the biological features of the tumor. In the present study, we investigated whether 4d real-time flow imaging is useful to display the accurate position of RFA needle in the tumor and evaluated the efficacy of therapy in patients with HCC.MethodsFifteen patients with HCC were admitted to our Hospital. Their diagnosis was confirmed by Dynamic CT and celiac angiography. Based on Child score, 14 patients were diagnoses as grade A, and 1 patient as grade B. All patients enrolled showed hypervascular enhancement of HCC on the contrast-enhanced US and/or Dynamic CT. The diameters of tumor were 1.1-2.0cm in 9 nodules,21.-3.0cm in 3,3.1-5.0cm in 3,respectively. All patients gave written informed consent, and this protocol has been approved by the Human Studies Committee at Masuko Memorial Hospital. US imaging used APLIO XG for RFA therapy with a convex probe as US system. 4D real-time refers here to the display of 3-dimensional moving imagings composed of 3 orthogonally intersecting scans in the transverse, longitudinal and horizontal planes. We used an RFA generator with 200W power connected to a 17-gauge perfusion needle.ResultsIt was possible to obtain an accurate position of the cool-tip needle and perform the RFA procedure in all HCC patients with 15 nodules using a 4D real-time APLIO XG US machine.We confirmed by various angles that the needle was inserted into the center of tumor nodules.The simultaneous study before RFA therapy showed the inflow of arterial blood and tumor stain, and importantly, it appeared that 4D real-time US provided much perceptible information on the spatial relationship between RFA needle and the target lesion and resulted in accurate therapeutic efficacy for percutaneous RFA procedure.ConclusionsWe experienced the treatment of 15 patients with HCC by RFA 4D real-time ultrasound system. The application of this method allowed a more accurate cauterization of the tumor.