Comparative study of shear wave velocities using acoustic radiation force impulse technology in hepatocellular carcinoma: the extent of radiofrequency ablation

Jiyoung Kang, Heejin Kwon, Jinhan Cho, Jongyoung Oh, Kyungjin Nam, Seongkuk Yoon, Myongjin Kang, Sungwook Lee, Sangyeong Han, Jiyoung Kang, Heejin Kwon, Jinhan Cho, Jongyoung Oh, Kyungjin Nam, Seongkuk Yoon, Myongjin Kang, Sungwook Lee, Sangyeong Han

Abstract

Background/aims: The purpose of this study was to assess the value of acoustic radiation force impulse (ARFI) for predicting the extent of radiofrequency ablation (RFA) in hepatocellular carcinoma (HCC) by correlating the elasticity of HCC and peritumoral parenchyma (as measured by ARFI) with the extent of ablation determined by computed tomography (CT).

Methods: From September 2009 to June 2011, 158 patients underwent RFA ablation for HCC (single, ≤3 cm). We evaluated the data of a total of 38 prospectively enrolled patients who underwent both ARFI imaging and contrast-enhanced CT after one session of 12 minutes of RFA without a change in needle position. The ARFI imaging indices, including the mean shear wave velocity (SWV) of HCC, mean SWV of the peritumoral parenchyma and tumor size, were evaluated to determine the statistical correlation with RFA extent after one session of 12 minutes of RFA.

Results: A stiffer liver parenchyma in patients with cirrhosis results in a smaller ablation zone.

Conclusions: SWV of ARFI in liver parenchyma was well correlated with RFA extent. After evaluating the correlation between ARFI and RFA extent, we suggest that the SWV in liver parenchyma might be a non-invasive supplementary tool for predicting the extent of RFA.

Keywords: Elasticity imaging techniques; Hepatocellular carcinoma; Radiofrequency ablation.

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Hepatocellular carcinoma (HCC) and underlying LC in S5 in the liver of a 56-year-old man. HCC and underlying liver cirrhosis in S5 of liver in a 56-year-old man. (A, B) On a B-mode image obtained using a 4-MHz curved array, the HCC appears as a well-defined, hypoechoic mass approximately 19.5 mm in size, located in the S5 segment of the liver. The HCC appears as dark coloration on real-time acoustic radiation force impulse imaging. (C, D) Measurement of shear wave velocity of the HCC and hepatic parenchyma at similar region of interest depths (5.4 and 5.5 cm below the skin) reveals that stiffer tumors display greater velocity (2.19 m/sec) than cirrhotic parenchyma (1.71 m/sec). (E) Post-radiofrequency ablation computed tomography scan in the arterial phase displays an oval, well-ablated and necrotic alteration in the HCC, which was (3.7×2.6×π)/4 cm2 in size.

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