The value of 64-slice spiral CT perfusion imaging in the treatment of liver cancer with argon-helium cryoablation

Abstract

We analyzed the effectiveness of using 64-slice spiral computed tomography (CT) and perfusion imaging to guide argon-helium cryoablation treatment of liver cancer. In total, 60 cases of advanced hepatocellular carcinoma before surgery treated with argon-helium cryoablation were inlcuded in the present study. Retrospective summary of the 60 cases of metaphase and advanced liver cancer were used as the control group. The control group were treated using cryoablation with argon-helium knife. We used enhanced scanning with 64-slice spiral CT to define the extent of their lesions and prepared a plan of percutaneous cryoablation for the treatment. Intraoperatively, we used the dynamics of CT perfusion imaging to observe the frozen ablation range and decreased the rate of complications. After surgery, the patients were followed-up regularly by 64-slice CT. We used conventional X-ray, CT and magnetic resonance imaging (MRI) for pre-operative lateralization. Intraoperative X-ray or ultrasound guidance and follow-up with CT or MTI were added to determine the clinical effectiveness and prognosis. The results showed that the total effective rate was improved significantly and incidence rate of overall complications decreased markedly in the observation group. Following treatment, AFP decreased significantly while the total freezing area and time were reduced significantly. The median survival time was increased significantly in the observation group. The numeric values of hepatic arterial perfusion, portal vein perfusion and hepatic arterial perfusion index were all markedly lowered after treatment. Differences were statistically significant (P<0.05). In conclusion, the use of 64-slice spiral CT perfusion imaging may considerably improve the effects of liver cancer treatment using the argon-helium cryoablation. It extended the survival time and reduced complications.

Keywords: 64-slice spiral computed tomography; cryoablation with argon-helium knife; perfusion imaging.

Figure 1.

Analysis of Kaplan-Meier in median survival time.

Figure 2.

The increase and perfusion of CT (red for high perfusion zone and blue for low perfusion zone). All changes in parameter of axial, coronary and sagittal pseudo color are in agreement. Tumors show high HAF, low HPE and high HAPI. Before treatment and in the increasing stage, there was sufficient blood that rapidly strengthened in the tumor. Ablation range expressed in arterial phase increased markedly after the treatment, tumors were all in low density and there was no consolidation. HAPI, hepatic arterial perfusion index; HAP, hepatic arterial perfusion.