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Evaluation of liver lesions by use of shear wave elastography and computed tomography perfusion imaging after radiofrequency ablation in clinically normal dogs

Dahae Lee DVM1, Seungjo Park DVM2, Mary Jasmin C. Ang DVM3, Jun-Gyu Park DVM, PhD4, Sooa Yoon DVM5, Cheolhyun Kim DVM6, Sang-kwon Lee DVM7, Kyoung-oh Cho DVM, PhD8, and Jihye Choi DVM, PhD9
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  • 1 College of Veterinary Medicine and BK 21 Plus Projection Team, Chonnam National University, Gwangju 61186, Republic of Korea.
  • | 2 College of Veterinary Medicine and BK 21 Plus Projection Team, Chonnam National University, Gwangju 61186, Republic of Korea.
  • | 3 College of Veterinary Medicine and BK 21 Plus Projection Team, Chonnam National University, Gwangju 61186, Republic of Korea.
  • | 4 College of Veterinary Medicine and BK 21 Plus Projection Team, Chonnam National University, Gwangju 61186, Republic of Korea.
  • | 5 College of Veterinary Medicine and BK 21 Plus Projection Team, Chonnam National University, Gwangju 61186, Republic of Korea.
  • | 6 College of Veterinary Medicine and BK 21 Plus Projection Team, Chonnam National University, Gwangju 61186, Republic of Korea.
  • | 7 College of Veterinary Medicine and BK 21 Plus Projection Team, Chonnam National University, Gwangju 61186, Republic of Korea.
  • | 8 College of Veterinary Medicine and BK 21 Plus Projection Team, Chonnam National University, Gwangju 61186, Republic of Korea.
  • | 9 College of Veterinary Medicine and BK 21 Plus Projection Team, Chonnam National University, Gwangju 61186, Republic of Korea.

Abstract

OBJECTIVE To evaluate acute changes of the liver by use of shear wave elastography (SWE) and CT perfusion after radiofrequency ablation (RFA).

ANIMALS 7 healthy Beagles.

PROCEDURES RFA was performed on the liver (day 0). Stiffness of the ablation lesion, transitional zone, and normal parenchyma were evaluated by use of SWE, and blood flow, blood volume, and arterial liver perfusion of those regions were evaluated by use of CT perfusion on days 0 and 4. All RFA lesions were histologically examined on day 4.

RESULTS Examination of the SWE color-coded map distinctly revealed stiffness of the liver tissue, which increased from the normal parenchyma to the transitional zone and then to the ablation zone. For CT perfusion, blood flow, blood volume, and arterial liver perfusion decreased from the transitional zone to the normal parenchyma and then to the ablation zone. Tissue stiffness and CT perfusion variables did not differ significantly between days 0 and 4. Histologic examination revealed central diffuse necrosis and peripheral hyperemia with infiltration of lymphoid cells and macrophages.

CONCLUSIONS AND CLINICAL RELEVANCE Coagulation necrosis induced a loss of blood perfusion and caused tissue hardening (stiffness) in the ablation zone. Hyperemic and inflammatory changes of the transitional zone resulted in increased blood perfusion. Acute changes in stiffness and perfusion of liver tissue after RFA could be determined by use of SWE and CT perfusion. These results can be used to predict the clinical efficacy of RFA and to support further studies, including those involving hepatic neoplasia.

Abstract

OBJECTIVE To evaluate acute changes of the liver by use of shear wave elastography (SWE) and CT perfusion after radiofrequency ablation (RFA).

ANIMALS 7 healthy Beagles.

PROCEDURES RFA was performed on the liver (day 0). Stiffness of the ablation lesion, transitional zone, and normal parenchyma were evaluated by use of SWE, and blood flow, blood volume, and arterial liver perfusion of those regions were evaluated by use of CT perfusion on days 0 and 4. All RFA lesions were histologically examined on day 4.

RESULTS Examination of the SWE color-coded map distinctly revealed stiffness of the liver tissue, which increased from the normal parenchyma to the transitional zone and then to the ablation zone. For CT perfusion, blood flow, blood volume, and arterial liver perfusion decreased from the transitional zone to the normal parenchyma and then to the ablation zone. Tissue stiffness and CT perfusion variables did not differ significantly between days 0 and 4. Histologic examination revealed central diffuse necrosis and peripheral hyperemia with infiltration of lymphoid cells and macrophages.

CONCLUSIONS AND CLINICAL RELEVANCE Coagulation necrosis induced a loss of blood perfusion and caused tissue hardening (stiffness) in the ablation zone. Hyperemic and inflammatory changes of the transitional zone resulted in increased blood perfusion. Acute changes in stiffness and perfusion of liver tissue after RFA could be determined by use of SWE and CT perfusion. These results can be used to predict the clinical efficacy of RFA and to support further studies, including those involving hepatic neoplasia.

Contributor Notes

Address correspondence to Dr. Choi (imsono@chonnam.ac.kr).