Correlation between Ultrasound Reflection Intensity and Tumor Ablation Ratio of Late-Stage Pancreatic Carcinoma in HIFU Therapy: Dynamic Observation on Ultrasound Reflection Intensity
Figure 2
A 44-year-old woman with about 9.3 × 8.4 × 8.7 cm metastatic pancreatic tail carcinoma. The pre-HIFU enhanced CT (a) showed low-density lesions in pancreatic tail with clear boundary, internal heterogeneous echo, small liquefaction necrosis, and internal inhomogeneous enhancement (b). Ultrasound (c) showed a hypoechoic pancreatic tail with a clear boundary, internal heterogeneous ultrasound reflection, and oval anechoic area. The CDFI (d) showed a rich blood flow signal in tumor parenchyma. In the 5th treatment, ultrasound showed air-like hyperechoic reflection within tumor parenchyma; CDFI showed significant decrease of blood flow signal in tumor parenchyma (e). In the 8th treatment, liquefaction necrosis area increased, liquefied surface formed through necrotic material deposition (f), and blood flow signal decreased significantly in tumor parenchyma (g). In 12th (h) and 17th (i) treatments, tumor parenchyma decreased while liquefaction necrosis inside significantly increased with floating pellets or tablets of necrotic materials. A month later, the axial (j) and coronal (k) enhanced CT showed significant tumor volume increase with internal large liquefaction necrosis, a little marginal parenchyma and tumor ablation ration over 70%.
