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ECR 2014 / C-2378
Reduce confusion! Using Combined Contrast ultrasound and fusion technique during RF ablation of liver SOL's
This poster was previously presented at the 69th Korean Congress of Radiology (KCR 2013) in Seoul. This poster is published under an open license. Please read the disclaimer for further details.
Congress: ECR 2014
Poster No.: C-2378
Type: Scientific Exhibit
Keywords: Liver, Interventional non-vascular, Oncology, Ultrasound, Percutaneous, CT, Ablation procedures, Contrast agent-other, Radiation therapy / Oncology, Cancer, Metastases, Cirrhosis
Authors: S. G. A. Momin, A. A. Momin; Mumbai/IN

Methods and materials

Nine consecutive liver lesions; four metastatic and five primary HCC were considered suitable for US guided radiofrequency ablation with earlier CECT or PET CT or contrast MRI. Total 4 metastatic lesions; one from breast and three from colonic primary are included in this study (Fig 12) .The size of these lesions was from 1.3cm to 4.7 cm located in various segments except caudate lobe. Using additional tools of CEUS or fusion imaging the pre, intra and immediate post RFA response was correctly judged; later confirmed on contrast enhanced CT or PET study.

In two cases  absolute alcohol was used for chemical ablation of small but critically located SOL's. In one case: to overcome heat sink effect due to its proximity to main portal vein (as shown in figure 6 and video 3) and in other case for its immediate subcapsular location(as shown in figure 10).

This study was done on various high-end ultrasound units with capability of contrast ultrasound and fusion imaging using DICOM Data of MDCT, MRI and PET Scanner along with multi-modality review facility (as shown in figure 8). Sulphur hexaflouride was used as intravenous-ultrasound contrast agent in appropriate dosage; which is approved in European and Asian countries. RF generator and type of electrode was decided as per the size and shape of the lesion being treated to achieve either more oblong or rounded spherical ablation zones (figure 1).

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