Ultrasound Overestimates the Area of Necrosis during Radiofrequency Ablation in Porcine Livers
Philippine Journals Online
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| Title |
Ultrasound Overestimates the Area of Necrosis during Radiofrequency Ablation in Porcine Livers
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| Creator |
Esperanza Grace Santi; Fellow, Section of Gastroenterology, Department of Internal Medicine, University of Santo Tomas Hospital, Manila
Sandy Lu; Resident, Department of Radiology, University of Santo Tomas Hospital, Manila Mario Milo; Consultant, Department of Radiology, University of Santo Tomas Hospital, Manila, Redigo Aguilar; Fellow, Section of Gastroenterology, Department of Internal Medicine, University of Santo Tomas Hospital, Manila Hendra Nurjadin; Fellow, Section of Gastroenterology, Department of Internal Medicine, University of Santo Tomas Hospital, Manila Susanne Gosalvez-Pe; Section of Gastroenterology, Department of Internal Medicine, University of Santo Tomas Hospital, Manila, Stephen Wong; Consultant, Section of Gastroenterology, Department of Internal Medicine, University of Santo Tomas Hospital, Manila |
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| Subject |
Radiology; Gastroenterology
Hepatocellular carcinoma; Radio frequency ablation (RFA); Ultrasound, porcine liver; liver treatment; hepatoma; HCC |
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| Description |
Background: Ultrasound is the most common imaging modality used to guide electrode insertion and estimate the necrotic zone during radiofrequency ablation (RFA) of hepatic tumors. However, most investigators agree that ultrasound inaccurately predicts the necrotic zone after RFA despite the scarcity of experimental and clinical evidence. Objective: We aimed to compare the necrotic diameter estimated from ultrasound during RFA with the actual gross diameter in ex vivo porcine livers. Methods: An internally-cooled electrode with a 3 cm uninsulated tip (Cooltip Radiofrequency System, Valleylab) was used to perform RFA for 6 and 12 minutes in ex vivo porcine livers under ultrasound guidance. Maximum horizontal and longitudinal diameters of the gross ablation zones were compared with the diameters of the hyperechoic zone created on ultrasound during RFA. Results: There was a trend for increased horizontal diameter for both ultrasound (RFA 6 mins=3.8±0.5cm vs. RFA 12 mins = 5.1±1.0cm; p = 0.079) and grossly (RFA 6mins = 2.7±0.27cm vs. RFA 12mins = 3.1±0.24cm; p = 0.068) with increased RFA duration from 6 to 12 minutes, which was not observed for the longitudinal diameter. Ultrasound consistently overestimated the actual necrotic diameter by 1.3±0.8cm (range = 0.4 to 3.6cm) (p = 0.01) whether RFA was performed for 6 (1.0±0.3cm) or 12 (1.8±1.2cm) minutes. Conclusion: Ultrasound led to overestimation of the true size of ablation zones regardless of the duration of ablation. The slight increase in the discrepancy with increased RFA duration suggests that an increased hyperechoic zone with prolonged ablation will not necessarily mean a proportionate increase in actual necrotic diameter. Keywords: Hepatocellular carcinoma; Radio frequency ablation (RFA); Ultrasound, porcine liver; liver treatment; hepatoma; HCC DOI: 10.3860/pjim.v47i3.1653 Phil. J. Internal Medicine, 47: 117-120, May-June, 2009
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| Publisher |
The Philippine College of Physicians
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| Contributor |
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| Date |
2010-07-23
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| Type |
Peer-Reviewed Article
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| Format |
application/pdf
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| Identifier |
http://www.philjol.info/index.php/PJIM/article/view/1653
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| Source |
Philippine Journal of Internal Medicine; Vol 47, No 3 (2009); 117-120
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| Language |
en
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| Coverage |
Philippines
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