Local tumor recurrence following hepatic cryoablation: Radiologic-histopathologic correlation in a rabbit model

被引:65
作者
Kuszyk, BS
Boitnott, JK
Choti, MA
Bluemke, DA
Sheth, S
Magee, CA
Horton, KM
Eng, J
Fishman, EK
机构
[1] Johns Hopkins Med Inst, Russell H Morgan Dept Radiol & Radiol Sci, Baltimore, MD 21287 USA
[2] Johns Hopkins Med Inst, Dept Pathol, Baltimore, MD 21287 USA
[3] Johns Hopkins Med Inst, Dept Surg, Baltimore, MD 21287 USA
关键词
animals cryotherapy; liver; interventional procedures; CT; MR; US; liver neoplasms;
D O I
10.1148/radiology.217.2.r00nv41477
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
PURPOSE: To use radiologic-histopathologic correlation in an animal model to distinguish normal postoperative findings from evidence of residual tumor after cryoablation of malignant hepatic tumors. MATERIALS AND METHODS: Hepatic cryoablation was performed in 12 rabbits with VX2 tumors and in two healthy rabbits. Nonenhanced and dynamic contrast material-enhanced computed tomography (CT) and magnetic resonance (MR) imaging and power and color Doppler flow ultrasonography (US) were performed 7-8 days after cryoablation. Histopathologic findings were correlated with imaging findings. RESULTS: Twenty tumors of 5-20 mm (mean, 10 mm) and seven areas of normal liver were treated with cryolesions of 11-21 mm (mean, 15 mm). All cryolesions exhibited arterial phase rim enhancement at Ci and MR imaging, and 13 (57%) of 23 lesions demonstrated peripheral flow at US because of granulation tissue. There was macroscopic recurrence in 15 (75%) of 20 treated tumors; 14 (93%) appeared as peripheral nodularity with low-grade enhancement. Necrotic tissue did not enhance. Intact vessels extended up to 6 mm inside cryolesion margins and caused focal internal enhancement and Doppler flow. Areas of high signal intensity on T2-weighted MR images correlated with liquefaction necrosis, granulation tissue, and tumor. CONCLUSION: In this animal model, recurrent tumor typically appeared as focal nodules at the cryolesion periphery. Rim and central foci of enhancement, Doppler flow, and increased signal intensity on TZ-weighted MR images can be normal findings after hepatic cryoablation.
引用
收藏
页码:477 / 486
页数:10
相关论文
共 49 条
[1]   Place of cryosurgery in the treatment of malignant liver tumors [J].
Adam, R ;
Akpinar, E ;
Johann, M ;
Kunstlinger, F ;
Majno, P ;
Bismuth, H .
ANNALS OF SURGERY, 1997, 225 (01) :39-49
[2]   The effects of hepatic cryosurgery on tumor growth in the liver [J].
Allen, PJ ;
D'Angelica, M ;
Hodyl, C ;
Lee, J ;
You, YJ ;
Fong, YM .
JOURNAL OF SURGICAL RESEARCH, 1998, 77 (02) :132-136
[3]   Radiofrequency ablation of unresectable primary and metastatic hepatic malignancies - Results in 123 patients [J].
Curley, SA ;
Izzo, F ;
Delrio, P ;
Ellis, LM ;
Granchi, J ;
Vallone, P ;
Fiore, F ;
Pignata, S ;
Daniele, B ;
Cremona, F .
ANNALS OF SURGERY, 1999, 230 (01) :1-8
[4]  
Daniel BL, 1999, MAGNET RESON MED, V41, P627, DOI 10.1002/(SICI)1522-2594(199903)41:3<627::AID-MRM28>3.0.CO
[5]  
2-Q
[6]   INTERSTITIAL RADIATION-THERAPY FOR HEPATIC METASTASES - SONOGRAPHIC GUIDANCE FOR APPLICATOR PLACEMENT [J].
DRITSCHILO, A ;
GRANT, EG ;
HARTER, KW ;
HOLT, RW ;
RUSTGI, SN ;
RODGERS, JE .
AMERICAN JOURNAL OF ROENTGENOLOGY, 1986, 147 (02) :275-278
[7]  
DVORAK HF, 1986, NEW ENGL J MED, V315, P1650
[8]   THERAPEUTIC EFFECT OF PERCUTANEOUS ETHANOL INJECTION ON SMALL HEPATOCELLULAR-CARCINOMA - EVALUATION WITH CT [J].
EBARA, M ;
KITA, K ;
SUGIURA, N ;
YOSHIKAWA, M ;
FUKUDA, H ;
OHTO, M ;
KONDO, F ;
KONDO, Y .
RADIOLOGY, 1995, 195 (02) :371-377
[9]  
FISHER B, 1959, CANCER, V12, P929, DOI 10.1002/1097-0142(195909/10)12:5<929::AID-CNCR2820120512>3.0.CO
[10]  
2-P