A case of hepatocellular carcinoma successfully treated by irreversible electroporation

Abstract

We report a woman in her late 60s with hepatocellular carcinoma in whom the tumor was successfully treated by irreversible electroporation (IRE). Vascular-phase contrast-enhanced US (CEUS) with Sonazoid and dynamic CT at 1 day after treatment showed no tumor enhancement, but the safety margin of ablation appeared to be insufficient. On the other hand, in Kupffer-phase CEUS, the ablation zone showed a clear contrast defect with a sufficient ablation margin, indicating cell death of hepatocytes, cancer cells, and Kupffer cells in this area following IRE treatment. Very similar findings were observed in hepatobiliary-phase Gd-EOB-DTPA-enhanced MRI at 7 days after treatment. These results suggest that both Kupffer-phase CEUS and hepatobiliary-phase Gd-EOB-DTPA-enhanced MRI may be useful for assessing the ablation zone in patients who have undergone IRE.