Usefulness of three-dimensional sonography in procedures of ablation for liver cancers: initial experience.
OBJECTIVE
To investigate the usefulness of three-dimensional sonography in procedures of ablation for liver cancers.


METHODS
Two- and three-dimensional sonography were used in guiding 18 chemical ablation procedures (7 with boiling carboplatin ablation and 11 with ethanol ablation) and 21 radio frequency ablation procedures for treatment of liver cancers. The applicator conspicuity depicted by the 2 imaging modalities, the confidence level of the operator in determining the position relationship between the applicator and the tumor using the 2 imaging modalities, and the alteration of ablation procedures were evaluated.


RESULTS
Three-dimensional sonography was better than two-dimensional sonography in delineation of multitined, expandable electrode tips in radio frequency ablation procedures, whereas the 2 modalities were equal in depicting percutaneous transhepatic cholangiography needle tips in chemical ablation procedures. Three-dimensional sonography significantly enhanced the confidence level in defining the spatial relationship between applicator and tumor in comparison with two-dimensional sonography (P < .01). Suboptimal applicator placement was detected in 6 (15%) of 39 ablation procedures on three-dimensional sonography: 3 chemical ablation procedures and 3 radio frequency ablation procedures. Applicator adjustment was required in 3 chemical ablation procedures. In 15 (38%) of 39 procedures, three-dimensional sonography allowed better visualization of the position relationship between the applicator and adjacent critical structures.


CONCLUSIONS
Three-dimensional sonography was useful in delineation of expandable radio frequency electrodes, improvement of operator confidence level, determination of applicator placement, and visualization of the position relationship between the applicator and adjacent critical structures during procedures of liver cancer ablation under image guidance.
Xu
Hui-Xiong
HX
Department of Medical Ultrasonics, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China.
Yin
Xiao-Yu
XY
Lu
Ming-De
MD
Xie
Xiao-Yan
XY
Xu
Zuo-Feng
ZF
Liu
Guang-Jian
GJ
D000328:Adult; D000368:Aged; D017115:Catheter Ablation; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D015552:Injections, Intralesional; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018084:Ultrasonography, Interventional