Role of contrast enhanced ultrasound in evaluating hepatic malignancies after ablation

Imaging evaluation of hepatic malignancies after ablation is an important clinical problem to be solved. Contrast enhanced ultrasound (CEUS) is a noninvasive, safe technique for acquiring the microcirculation information of treatment areas. The CEUS technique and the findings of local and distant recurrence were reviewed. Complete ablation was defined as follows: the ablation area had neither enhancement nor abnormal wash-out and was presented as perfusion deficiency in each phase of CEUS. Local residual or recurrent tumor had various patterns, and their common location was in the periphery of the lesions, being nodular or in irregular enhancement. The positive indicator of recurrence was that CEUS found abnormal enhancement in arterial phase. Most lesions with viability can be detected by this criteria. During follow-up, local recurrence or viability of tumor should be considered when the lesion was increased in size. Most current studies have demonstrated that CEUS has a similar value as contrast enhanced computed tomography in evaluating hepatic malignancies after ablation and that CEUS offers an imaging option for treatment evaluation and follow-up.