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Sonographically Observed Echogenic Response During Intraoperative Radiofrequency Ablation of Cirrhotic Livers

Pathologic Correlation

John R. Leyendecker1, Gerald D. Dodd, III1, Glenn A. Halff2, Victor A. McCoy1, Dacia H. Napier1, Linda G. Hubbard1, Kedar N. Chintapalli1, Shailendra Chopra1, W. Kenneth Washburn2, Robert M. Esterl2, Francisco G. Cigarroa2, Ruth E. Kohlmeier3 and Francis E. Sharkey3

1 Department of Radiology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr., San Antonio, TX 78284-7800.
2 Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX 78284-7800.
3 Department of Pathology, University of Texas Health Science Center at San Antonio, San Antonio, TX 78284-7800.



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  		Fig. 1A. —Method of measuring echogenic response and tissue necrosis. Sonogram obtained during radiofrequency ablation shows typical hyperechoic region surrounding needle electrode. Diameter of echogenic response (arrowheads) is measured as close to perpendicular to needle (arrow) as possible.

 


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  		Fig. 1B. —Method of measuring echogenic response and tissue necrosis. Photograph of pathologic specimen shows pale tissue centrally corresponding to area of complete tissue necrosis (arrowheads). Surrounding hemorrhagic rim (arrow) was excluded from measurements.

 


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  		Fig. 2. —Scatter plot shows correlation between mean diameter of necrosis determined at pathology and diameter of echogenic response measured on sonography. Dashed line represents perfect correlation. In general, as diameter of echogenic response increases, mean diameter of necrosis increases.

 


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  		Fig. 3. —Scatter plot shows correlation between minimum diameter of necrosis determined at pathology and diameter of echogenic response measured on sonography. Dashed line represents perfect correlation. Note that most data points fall below line of perfect correlation, indicating that diameter of echogenic response overestimated short axis of ablation in most cases.

 

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