Role of ultrasound in the assessment of percutaneous laser ablation of cervical metastatic lymph nodes from thyroid carcinoma

Acta Radiol. 2018 Apr;59(4):434-440. doi: 10.1177/0284185117721261. Epub 2017 Aug 8.

Abstract

Background Few studies have examined the feasibility and efficiency of performing ultrasound and contrast-enhanced ultrasound (CEUS) after percutaneous laser ablation (PLA) of cervical metastatic lymph nodes from thyroid cancer. Purpose To investigate and describe the use of conventional ultrasound and CEUS in evaluating PLA of metastatic lymph nodes. Material and Methods PLA was performed in a small, prospective, observational study of 21 metastatic lymph nodes in 17 thyroid cancer patients who underwent radical thyroid resection. CEUS was conducted prior to PLA and 1 h and seven days after ablation. Conventional ultrasound examination of all nodes was performed during follow-up after ablation. We observed contrast agent perfusion in the lymph nodes, calculated perfusion defect volumes using CEUS and determined the rates of reduction for metastatic lymph nodes for a mean duration of 17.86 ± 4.704 months (range = 12-27 months). Results CEUS demonstrated that the perfusion defect volume was larger on day 7 than on day 1 post-ablation in 47% of the ablated nodes. Compared to the largest diameters and volumes pre-PLA, the corresponding post-PLA values significantly decreased ( P < 0.05 versus baseline). No statistically significant change in thyroglobulin (Tg) levels before and after PLA was observed in this study ( P > 0.05 versus baseline). Conclusion CEUS can be effectively used to distinguish the margins of ablated regions, assess the accuracy of PLA, and monitor short-term changes in necrotic areas. However, long-term follow-up assessments of the curative effect of PLA will predominantly rely on conventional ultrasonography.

Keywords: Percutaneous; intravenous contrast agents; laser; lymphatic; metastases; ultrasound.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Contrast Media*
  • Feasibility Studies
  • Female
  • Humans
  • Image Enhancement
  • Laser Therapy / methods*
  • Lasers
  • Lymph Nodes / surgery*
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neck
  • Phospholipids*
  • Prospective Studies
  • Reproducibility of Results
  • Sulfur Hexafluoride*
  • Thyroid Neoplasms / pathology*
  • Treatment Outcome
  • Ultrasonography, Doppler, Color / methods*
  • Young Adult

Substances

  • Contrast Media
  • Phospholipids
  • contrast agent BR1
  • Sulfur Hexafluoride