Percutaneous irreversible electroporation (IRE) of hepatic malignant tumours: Contrast-enhanced ultrasound (CEUS) findings

Purpose: The aim of this study is to describe the image findings of contrast-enhanced ultrasound (CEUS) after irreversible electroporation (IRE), and to assess its usefulness in relation to the evaluation of the ablation status using a dynamic recording of the microvascularisation. Material and method: In this prospectively designed study, a percutaneous IRE was performed for the treatment of malignant hepatic lesions in a total of 15 patients following the interdisciplinary diagnosis. The lesions were documented using CEUS before, immediately after and 20 minutes after the ablation. The acquired CEUS image data was subsequently independently retrospectively evaluated by 2 experienced radiologists and assessed in relation to microvascularisation using a 5 point scale. Results: Using CEUS, a significant reduction in the microcirculation of the lesions, both centrally and marginally, could be detected following IRE (p<0.001 and p<0.001). The mean evaluation of the central microcirculation was reduced from 3.13 +/- 1.38 to 0.47 +/- 0.64 (p<0.01). For the peripheral area of the lesion and the ablation margin, there was a reduction of 3.37 +/- 1.13 to 1.57 +/- 0.46 (p=0.001). There was no significant reduction in the macrocirculation. Conclusion: Within the framework of this study, it could be demonstrated that, in the course of IRE, a rapid significant reduction of the microcirculation in the ablation area occurred.