title: Microwave ablation of large HCC lesions: Added value of CEUS examinations for ablation success control.
abstract: OBJECTIVE
  To assess the value of dynamic contrast enhanced ultrasound (CEUS) for the detection of residual tumor tissue day 1 after microwave ablation (MWA) of large hepatocellular carcinoma (HCC) compared to MRI.
  
  
  METHODS
  30 consecutive patients (5 females, 25 males, mean age 64 years, age range 54-73 years) with an untreated HCC lesion larger than or equal to 3 cm underwent percutaneous MWA between 03/2014 and 04/2016. 1 patient was excluded because of an artificial pacemaker. All remaining 29 patients underwent 3-T MRI with liver-specific contrast agent and CEUS 1 day after ablation to detect residual tumor tissue. The 6-week follow-up including CEUS and MRI was defined as the reference standard.
  
  
  RESULTS
  Complete ablation was achieved in 23 of 29 treated lesions (79%). The sensitivities and specificities for the detection of residual tumor tissue on day 1 were 100% and 83% for CEUS and 87% and 67% for MRI resp. without the differences being statistically significant.
  
  
  CONCLUSIONS
  CEUS allows a reliable assessment of therapeutic success of percutaneous ablation of large HCC lesions one day after the ablation. Its ability to visualize reactive periablation perfusion changes in real-time might be of advantage in the depiction of residual tumor tissue when compared to MRI imaging alone.
authors.forename: B
authors.initials: B
authors.lastname: Pregler
authors.forename: L P
authors.initials: LP
authors.lastname: Beyer
authors.forename: I
authors.initials: I
authors.lastname: Wiesinger
authors.forename: C
authors.initials: C
authors.lastname: Nießen
authors.forename: E M
authors.initials: EM
authors.lastname: Jung
authors.forename: C
authors.initials: C
authors.lastname: Stroszczynski
authors.forename: P
authors.initials: P
authors.lastname: Wiggermann
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014463:Ultrasonography / Q000379:methods*
keywords: Contrast-enhanced ultrasound (CEUS); hepatocellular carcinoma (HCC); imaging findings; microwave ablation (MWA)