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Multimodality imaging to assess immediate response following irreversible electroporation in patients with malignant hepatic tumors

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Abstract

Purpose

To assess the diagnostic accuracy of contrast-enhanced ultrasound (CEUS), contrast-enhanced multiphase CT (CECT), and gadoxetic acid-enhanced MRI (EOB-MRI) in identifying residual tumor in the subacute follow-up of patients with malignant hepatic tumors treated by irreversible electroporation (IRE).

Methods

We enrolled 16 patients with 21 hepatic lesions treated by IRE and examined by CEUS and CECT at 1 day after IRE and by EOB-MRI at 7 days after IRE. Follow-up examinations by EOB-MRI or CECT and CEUS were performed at 3-month intervals. Two radiologists independently reviewed the images and assessed the probability of residual tumor using a five-point scale with receiver operating characteristic (ROC) curve analysis. The sensitivity and specificity were also evaluated. Verifiable local recurrence was assessed using follow-up imaging as the reference standard.

Results

The mean area under the ROC curve was significantly higher for CEUS (0.980) than for CECT (0.742, P < 0.01) and EOB-MRI (0.806, P < 0.01), as were the sensitivity and specificity (mean 85.7 and 85.7% for CEUS, respectively, vs 64.3 and 46.4% for CECT and 78.6 and 64.3% for EOB-MRI).

Conclusion

CEUS was found to be superior to CECT and EOB-MRI for the diagnosis of residual tumor in the subacute phase following IRE.

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Acknowledgements

This work was supported by MEXT KAKENHI Grant Number 26865030. The authors would like to thank Dr. Toru Saguchi for image interpretation.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan

    Katsutoshi Sugimoto, Yoshiyuki Kobayashi & Takao Itoi

  2. Department of Gastroenterology and Hepatology, International University of Health and Welfare, Sanno Hospital, Tokyo, Japan

    Fuminori Moriyasu

  3. Department of Radiology, Tokyo Medical University, Tokyo, Japan

    Kazuhiro Saito

Authors
  1. Katsutoshi Sugimoto
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  2. Fuminori Moriyasu
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  3. Kazuhiro Saito
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  4. Yoshiyuki Kobayashi
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  5. Takao Itoi
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Corresponding author

Correspondence to Katsutoshi Sugimoto.

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The authors declare that they have no conflicts of interest.

Human rights statements and informed consent

All procedures followed were in accordance with the ethical standards of the responsible committees on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008. Informed consent was obtained from all patients before inclusion in the study.

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Sugimoto, K., Moriyasu, F., Saito, K. et al. Multimodality imaging to assess immediate response following irreversible electroporation in patients with malignant hepatic tumors. J Med Ultrasonics 44, 247–254 (2017). https://doi.org/10.1007/s10396-016-0767-0

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  • DOI: https://doi.org/10.1007/s10396-016-0767-0

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