Interventional procedures for percutaneous tumor ablation have gained an increasingly important role in the treatment of liver malignancies. After interventional therapies, diagnostic imaging has the key role to determine if the treated lesion is completely ablated or contains areas of residual viable neoplastic tissue. This is particularly important since in cases of incomplete necrosis of the lesions, treatment can be repeated, and tumor ablation can be further pursued. The evaluation of the therapeutic effect of the procedure arises different problems according to the histotype of the malignancy. In the case of hepatocellular carcinoma (HCC), detection of residual viable tumor is facilitated by the typical hypervascular pattern of this neoplasm. Contrast-enhanced US can be used to monitor tumor response, and, in cases of partial necrosis, to target the areas of residual viable tumor. With spiral CT or dynamic MR imaging, residual viable HCC is reliably depicted as it stands out in the arterial phase images against the unenhanced areas of coagulation necrosis. In the case of hypovascular metastases, a confident diagnosis of successfull ablation can be made when an area of thermal necrosis exceeding that of the original lesion is depicted. Peripheral inflammatory reaction following ablation procedures, that shows itself as an enhancing halo along the necrotic area boundary on spiral CT or dynamic MR images, should not be misinterpreted as tumor progression

Percutaneous ablation of liver malignancies: imaging evaluation of treatment response

CIONI, DANIA;LENCIONI, RICCARDO ANTONIO;
2001-01-01

Abstract

Interventional procedures for percutaneous tumor ablation have gained an increasingly important role in the treatment of liver malignancies. After interventional therapies, diagnostic imaging has the key role to determine if the treated lesion is completely ablated or contains areas of residual viable neoplastic tissue. This is particularly important since in cases of incomplete necrosis of the lesions, treatment can be repeated, and tumor ablation can be further pursued. The evaluation of the therapeutic effect of the procedure arises different problems according to the histotype of the malignancy. In the case of hepatocellular carcinoma (HCC), detection of residual viable tumor is facilitated by the typical hypervascular pattern of this neoplasm. Contrast-enhanced US can be used to monitor tumor response, and, in cases of partial necrosis, to target the areas of residual viable tumor. With spiral CT or dynamic MR imaging, residual viable HCC is reliably depicted as it stands out in the arterial phase images against the unenhanced areas of coagulation necrosis. In the case of hypovascular metastases, a confident diagnosis of successfull ablation can be made when an area of thermal necrosis exceeding that of the original lesion is depicted. Peripheral inflammatory reaction following ablation procedures, that shows itself as an enhancing halo along the necrotic area boundary on spiral CT or dynamic MR images, should not be misinterpreted as tumor progression
2001
Cioni, Dania; Lencioni, RICCARDO ANTONIO; Bartolozzi, C.
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11568/177046
 Attenzione

Attenzione! I dati visualizzati non sono stati sottoposti a validazione da parte dell'ateneo

Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 33
  • ???jsp.display-item.citation.isi??? ND
social impact