Percutaneous Radiofrequency Ablation Guided by Contrast-enhanced Ultrasound in Treatment of Metastatic Hepatocellular Carcinoma after Liver Transplantation

Abstract

This study evaluated the advantages and applications of contrast-enhanced ultrasound (CEUS)-supported percutaneous radiofrequency ablation (RFA) in the treatment of metastatic hepatocellular carcinoma after liver transplantation, based on clinical details. CEUS-supported percutaneous RFA was adopted to treat 12 patients with hepatic metastatic carcinomas after liver transplantation. The diameters of the metastatic carcinomas varied from 1 cm to 5 cm, and the foci were discovered after 3 months to 12 months. Each focus was diagnosed and localised by CEUS for RFA once or twice. Curative effects were evaluated by CEUS or contrast-enhanced CT after the treatment. The re-examination results at 2 weeks post-treatment showed that the foci of 11 patients were ablated completely, whereas one patient with the largest focus required retreatment by RFA because of a partial residue. No local recurrence was found one month later in the re-examination. CEUS-supported percutaneous RFA in the treatment of hepatic metastatic carcinoma after liver transplantation has the advantages of accurate localisation, good efficacy, easy operation, and minimal invasion without any complications. Therefore, it can be recommended as the preferred therapy for hepatic metastatic carcinoma after liver transplantation.

Use of Ultrasound Contrast Agents in Relation to Percutaneous Interventional Procedures: A Systematic Review and Pictorial Essay

“…This indication is by far the largest subsection of CEUS‐guided procedures, and the use of CEUS in this regard falls into 3 categories: (1) CEUS visualization of the ablation target; (2) intraprocedural guidance and immediate postablation evaluation; and (3) ablation evaluation and follow‐up. A total of 25 articles were identified by the systematic search . They were all case series, and many had a retrospective design.…”

“…Eleven studies reported feasibility or technical success rates for CEUS‐guided percutaneous ablation in the range of 92% to 100%, and the rates of clinical or technical effectiveness, which was defined as immediate complete tumor necrosis, were 90% to 100% . Regarding immediate postablation assessments of treatments, a remarkably high benefit of CEUS was reported in a prospective feasibility study of 22 mixed liver malignancies using intraprocedural and immediate postablation CEUS assessments of tumor ablation during CT‐guided RF ablation.…”

Prognostic Value of Serum AFP, AFP-L3, and GP73 in Monitoring Short-term Treatment Response and Recurrence of Hepatocellular Carcinoma after Radiofrequency Ablation

“…Moreover, if patients with HCC who were not candidates for surgical resection or liver transplantation underwent RFA, their 5-year overall survival rates could be improved to 37% (Llovet and Bruix 2000;Ioannou et al, 2008). Xin Dai et al (Dai et al, 2012) recently demonstrated that RFA also had the advantages of accurate localization, good efficacy, easy operation, and minimal invasion without any complications in the treatment of HCC recurrence after liver transplantation. In our study AFP, AFP-L3, and GP-73 levels all sharply decreased after RFA, which indicated that these tumor markers could reflect the tumor burden and demonstrate the efficacy of RFA.…”

In Vivo Experimental Study on the Effects of Fluid in Increasing the Efficiency of Radiofrequency Ablation

“…With RFA alone, the melting range is limited (Ji and Xu, 2011;Dai et al, 2012;Hofer et al, 2008). When we injected 5% hypertonic saline, lidocaine or a mixed solution, increased ion concentrations were noted in the ablation areas.…”