Sonographically observed echogenic response during intaoperative radiofrequency ablation of cirrhotic livers: Pathologic correlation

John R. Leyendecker, Gerald D. Dodd, Glenn A. Halff, Victor A. McCoy, Dacia H. Napier, Linda G. Hubbard, Kedar N. Chintapalli, Shailendra Chopra, W. Kenneth Washburn, Robert M. Esterl, Francisco G. Cigarroa, Ruth E. Kohlmeier, Francis E. Sharkey

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Abstract

OBJECTIVE. We performed a study to determine the correlation between the diameter of the echogenic response observed with intraoperative sonography during radiofrequency ablation of the cirrhotic liver and the mean diameter of tissue necrosis. SUBJECTS AND METHODS. A total of 22 intraoperative radiofrequency ablations were created in 11 cirrhotic livers. The largest diameter of the sonographically observed echogenic response surrounding and perpendicular to the radiofrequency probe was measured. The subsequent zone of necrosis observed at pathology in the hepatectomy specimens after liver transplantation was measured in three planes and compared with the measured diameter of the echogenic response. RESULTS. During all except three ablations, a hyperechoic region was visualized surrounding the radiofrequency probe. The diameter of the echogenic response correlated significantly with the mean diameter of necrosis (correlation coefficient, 0.84). However, the echogenic response overestimated the minimal diameter of necrosis (mean difference, 0.8 ± 0.4 cm) in 18 of 22 ablations and underestimated the maximum diameter of necrosis (mean difference, 0.9 ± 0.8 cm) in 16 of 22 ablations. CONCLUSION. The diameter of the echogenic response observed with intraoperative sonography during radiofrequency ablation of the cirrhotic liver correlates closely with the mean diameter of the subsequent area of tissue necrosis. However, the solitary diameter of the echogenic response as measured in our study was often greater than the smallest diameter and less than the largest diameter of the area of tissue necrosis. Therefore, the echogenic response associated with radiofrequency ablation of the cirrhotic liver should be viewed only as a rough approximation of the area of induced tissue necrosis; the final assessment of the adequacy of ablation should be deferred to an alternative imaging technique.

Original languageEnglish (US)
Pages (from-to)1147-1151
Number of pages5
JournalAmerican Journal of Roentgenology
Volume178
Issue number5
StatePublished - Apr 30 2002

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Necrosis
Liver
Ultrasonography
Hepatectomy
Liver Transplantation
Pathology

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Leyendecker, J. R., Dodd, G. D., Halff, G. A., McCoy, V. A., Napier, D. H., Hubbard, L. G., ... Sharkey, F. E. (2002). Sonographically observed echogenic response during intaoperative radiofrequency ablation of cirrhotic livers: Pathologic correlation. American Journal of Roentgenology, 178(5), 1147-1151.

Sonographically observed echogenic response during intaoperative radiofrequency ablation of cirrhotic livers : Pathologic correlation. / Leyendecker, John R.; Dodd, Gerald D.; Halff, Glenn A.; McCoy, Victor A.; Napier, Dacia H.; Hubbard, Linda G.; Chintapalli, Kedar N.; Chopra, Shailendra; Washburn, W. Kenneth; Esterl, Robert M.; Cigarroa, Francisco G.; Kohlmeier, Ruth E.; Sharkey, Francis E.

In: American Journal of Roentgenology, Vol. 178, No. 5, 30.04.2002, p. 1147-1151.

Research output: Contribution to journalArticle

Leyendecker, JR, Dodd, GD, Halff, GA, McCoy, VA, Napier, DH, Hubbard, LG, Chintapalli, KN, Chopra, S, Washburn, WK, Esterl, RM, Cigarroa, FG, Kohlmeier, RE & Sharkey, FE 2002, 'Sonographically observed echogenic response during intaoperative radiofrequency ablation of cirrhotic livers: Pathologic correlation', American Journal of Roentgenology, vol. 178, no. 5, pp. 1147-1151.
Leyendecker, John R. ; Dodd, Gerald D. ; Halff, Glenn A. ; McCoy, Victor A. ; Napier, Dacia H. ; Hubbard, Linda G. ; Chintapalli, Kedar N. ; Chopra, Shailendra ; Washburn, W. Kenneth ; Esterl, Robert M. ; Cigarroa, Francisco G. ; Kohlmeier, Ruth E. ; Sharkey, Francis E. / Sonographically observed echogenic response during intaoperative radiofrequency ablation of cirrhotic livers : Pathologic correlation. In: American Journal of Roentgenology. 2002 ; Vol. 178, No. 5. pp. 1147-1151.
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abstract = "OBJECTIVE. We performed a study to determine the correlation between the diameter of the echogenic response observed with intraoperative sonography during radiofrequency ablation of the cirrhotic liver and the mean diameter of tissue necrosis. SUBJECTS AND METHODS. A total of 22 intraoperative radiofrequency ablations were created in 11 cirrhotic livers. The largest diameter of the sonographically observed echogenic response surrounding and perpendicular to the radiofrequency probe was measured. The subsequent zone of necrosis observed at pathology in the hepatectomy specimens after liver transplantation was measured in three planes and compared with the measured diameter of the echogenic response. RESULTS. During all except three ablations, a hyperechoic region was visualized surrounding the radiofrequency probe. The diameter of the echogenic response correlated significantly with the mean diameter of necrosis (correlation coefficient, 0.84). However, the echogenic response overestimated the minimal diameter of necrosis (mean difference, 0.8 ± 0.4 cm) in 18 of 22 ablations and underestimated the maximum diameter of necrosis (mean difference, 0.9 ± 0.8 cm) in 16 of 22 ablations. CONCLUSION. The diameter of the echogenic response observed with intraoperative sonography during radiofrequency ablation of the cirrhotic liver correlates closely with the mean diameter of the subsequent area of tissue necrosis. However, the solitary diameter of the echogenic response as measured in our study was often greater than the smallest diameter and less than the largest diameter of the area of tissue necrosis. Therefore, the echogenic response associated with radiofrequency ablation of the cirrhotic liver should be viewed only as a rough approximation of the area of induced tissue necrosis; the final assessment of the adequacy of ablation should be deferred to an alternative imaging technique.",
author = "Leyendecker, {John R.} and Dodd, {Gerald D.} and Halff, {Glenn A.} and McCoy, {Victor A.} and Napier, {Dacia H.} and Hubbard, {Linda G.} and Chintapalli, {Kedar N.} and Shailendra Chopra and Washburn, {W. Kenneth} and Esterl, {Robert M.} and Cigarroa, {Francisco G.} and Kohlmeier, {Ruth E.} and Sharkey, {Francis E.}",
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T1 - Sonographically observed echogenic response during intaoperative radiofrequency ablation of cirrhotic livers

T2 - Pathologic correlation

AU - Leyendecker, John R.

AU - Dodd, Gerald D.

AU - Halff, Glenn A.

AU - McCoy, Victor A.

AU - Napier, Dacia H.

AU - Hubbard, Linda G.

AU - Chintapalli, Kedar N.

AU - Chopra, Shailendra

AU - Washburn, W. Kenneth

AU - Esterl, Robert M.

AU - Cigarroa, Francisco G.

AU - Kohlmeier, Ruth E.

AU - Sharkey, Francis E.

PY - 2002/4/30

Y1 - 2002/4/30

N2 - OBJECTIVE. We performed a study to determine the correlation between the diameter of the echogenic response observed with intraoperative sonography during radiofrequency ablation of the cirrhotic liver and the mean diameter of tissue necrosis. SUBJECTS AND METHODS. A total of 22 intraoperative radiofrequency ablations were created in 11 cirrhotic livers. The largest diameter of the sonographically observed echogenic response surrounding and perpendicular to the radiofrequency probe was measured. The subsequent zone of necrosis observed at pathology in the hepatectomy specimens after liver transplantation was measured in three planes and compared with the measured diameter of the echogenic response. RESULTS. During all except three ablations, a hyperechoic region was visualized surrounding the radiofrequency probe. The diameter of the echogenic response correlated significantly with the mean diameter of necrosis (correlation coefficient, 0.84). However, the echogenic response overestimated the minimal diameter of necrosis (mean difference, 0.8 ± 0.4 cm) in 18 of 22 ablations and underestimated the maximum diameter of necrosis (mean difference, 0.9 ± 0.8 cm) in 16 of 22 ablations. CONCLUSION. The diameter of the echogenic response observed with intraoperative sonography during radiofrequency ablation of the cirrhotic liver correlates closely with the mean diameter of the subsequent area of tissue necrosis. However, the solitary diameter of the echogenic response as measured in our study was often greater than the smallest diameter and less than the largest diameter of the area of tissue necrosis. Therefore, the echogenic response associated with radiofrequency ablation of the cirrhotic liver should be viewed only as a rough approximation of the area of induced tissue necrosis; the final assessment of the adequacy of ablation should be deferred to an alternative imaging technique.

AB - OBJECTIVE. We performed a study to determine the correlation between the diameter of the echogenic response observed with intraoperative sonography during radiofrequency ablation of the cirrhotic liver and the mean diameter of tissue necrosis. SUBJECTS AND METHODS. A total of 22 intraoperative radiofrequency ablations were created in 11 cirrhotic livers. The largest diameter of the sonographically observed echogenic response surrounding and perpendicular to the radiofrequency probe was measured. The subsequent zone of necrosis observed at pathology in the hepatectomy specimens after liver transplantation was measured in three planes and compared with the measured diameter of the echogenic response. RESULTS. During all except three ablations, a hyperechoic region was visualized surrounding the radiofrequency probe. The diameter of the echogenic response correlated significantly with the mean diameter of necrosis (correlation coefficient, 0.84). However, the echogenic response overestimated the minimal diameter of necrosis (mean difference, 0.8 ± 0.4 cm) in 18 of 22 ablations and underestimated the maximum diameter of necrosis (mean difference, 0.9 ± 0.8 cm) in 16 of 22 ablations. CONCLUSION. The diameter of the echogenic response observed with intraoperative sonography during radiofrequency ablation of the cirrhotic liver correlates closely with the mean diameter of the subsequent area of tissue necrosis. However, the solitary diameter of the echogenic response as measured in our study was often greater than the smallest diameter and less than the largest diameter of the area of tissue necrosis. Therefore, the echogenic response associated with radiofrequency ablation of the cirrhotic liver should be viewed only as a rough approximation of the area of induced tissue necrosis; the final assessment of the adequacy of ablation should be deferred to an alternative imaging technique.

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