Elastographic imaging of thermal lesions in the liver in vivo following radiofrequency ablation: preliminary results

Radiofrequency (RF) ablation is an interstitial focal ablative therapy that can be used in a percutaneous fashion. This modality provides in situ destruction of hepatic tumors. However, local recurrence rates after RF ablative therapy are as high as 34% to 55%, believed to be due in part to the inability to visualize accurately the zone of necrosis (thermal lesion). This can lead to the incomplete ablation of the tumor, generally in areas near the tumor edges. In this paper, we show that ultrasound (US)-based in vivo elastography can accurately depict thermal lesions after thermal therapy. However, elastography of the liver and other abdominal organs is challenging due to the difficulty in providing controlled and reproducible compression. The use of the RF ablation probe as the compressor/displacement device reduces lateral slippage or nonaxial motion that may occur with externally applied compressions or imaging during the respiratory cycle. This technique also provides controlled and reproducible compressions of the liver for in vivo elastographic imaging. Comparison of elastograms with histology of ablated tissue demonstrates a close relationship between elastographic image features and histopathology.