Loss, Martin and Schneider, Julia and Uller, Wibke and Wiggermann, P. and Scherer, Marcus N. and Jung, Wolfgang and Schlitt, Hans J. and Stroszczynski, Christian and Jung, Ernst M. (2012) Intraoperative high resolution linear contrast enhanced ultrasound (IOUS) for detection of microvascularization of malignant liver lesions before surgery or radiofrequeny ablation. CLINICAL HEMORHEOLOGY AND MICROCIRCULATION, 50 (1-2). pp. 65-77. ISSN 1386-0291,
Full text not available from this repository. (Request a copy)Abstract
Objective: The aim of this study was to evaluate the value of linear contrast enhanced intraoperative ultrasound (CE-IOUS) to improve detection of malign liver tumors lesions before surgery or radiofrequency ablation (RFA). Materials and Methods: 50 patients were included for surgery of malignant liver tumors (mean age 61 years (19-80); male n = 35, female n = 15), suffering from HCC (n = 15), colorectal liver-metastasis (n = 28), CCC (n = 2) or other malign liver lesions (n = 5). Preoperative CE-CT (n = 38), CE-MRI (n = 23) or PET-CT (n = 8) confirmed hepatic tumor manifestation. Before undergoing surgery, intraoperative conventional (IOUS) as well as CE-IOUS were performed by one experienced examiner in all cases using multifrequency linear probes (6-9 MHz, 6-15 MHz; LOGIQ E9; GE Healthcare, Milwaukee, WI, USA). CE-IOUS was performed after bolus injection of 5 ml up to 15 ml SonoVue (R) (Bracco Imaging SpA, Milan, Italy). Digitally stored images of CE-IOUS were compared with fundamental B-Scan and preoperative imaging (CE-CT, CE-MRI and PET-CET). Results: In 28 of 50 patients (56%), additional lesions were found using CE-IOUS (mean tumor size 8 mm, range 4-12 mm). This resulted in a change of surgical strategy or the intraoperative application of RFA in 27 patients (54%). Modification of therapy due to additionally found liver lesions was statistically significant (p < 0.05). Comparing conventional IOUS and CE-IOUS, 14 additional lesions in 10 patients were seen by CE-IOUS. All lesions seen in B-scan could also be detected with CE-IOUS. Summary: This is the first study using contrast-enhanced ultrasound with high resolution linear probes for intraoperative detection of malignant liver lesions. Compared to preoperative imaging and also conventional IOUS more than 50% additional lesions were found leading to therapeutic consequences of patients. A recently started prospective study has to show whether these changes in the surgical or interventional therapy will influence morbidity, mortality and especially the recurrence rate.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | COLORECTAL-CANCER; HEPATOCELLULAR-CARCINOMA; METASTASES; ULTRASONOGRAPHY; SONOGRAPHY; TUMORS; RESECTION; AGENTS; Contrast enhanced ultrasound (CEUS); intraoperative ultrasound (IOUS); intraoperative imaging; liver lesion |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Chirurgie Medicine > Lehrstuhl für Röntgendiagnostik |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 25 May 2020 10:10 |
| Last Modified: | 25 May 2020 10:10 |
| URI: | https://pred.uni-regensburg.de/id/eprint/19523 |
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