Microwave thermal ablation monitoring using echo decorrelation imaging in patients with hepatocellular carcinoma
Abstract
Microwave ablation (MWA) is an increasingly important approach for thermal ablation of liver tumors, and is characterized by rapid increases in tissue temperature, generally causing larger ablation zones than radiofrequency ablation. Accurate real-time prediction of MWA treatment outcomes could improve MWA safety by avoiding overtreatment and damage to vulnerable structures near the targeted ablation zone. Previous studies have shown that echo decorrelation imaging can predict ablation effects in real time. Here, the feasibility of monitoring percutaneous MWA of hepatocellular carcinoma (HCC) using echo decorrelation imaging was tested in a clinical study with Institutional Review Board approval. Consenting subjects were recruited from patients scheduled for standard-of-care HCC ablation. Subjects underwent MWA guided by B-mode ultrasound (US) with imaging frequency 2.2 MHz. Throughout each ablation procedure, groups of 20 sequential beamformed RF frames were acquired at 30 s intervals. Acquired beamformed frames were used to compute B-mode US, echo decorrelation, and integrated backscattered (IBS) images. B-mode US images were co-registered with follow-up triphasic CT images. Receiver operating characteristic (ROC) curves were calculated to assess prediction of local ablation by thresholded echo decorrelation and IBS maps. Area under ROC curves showed that echo decorrelation imaging predicted local percutaneous MWA significantly better than IBS imaging in patients with HCC.
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