So Jung Lee1, Hyung Jin Won1, Kyung Won Kim1, Yong Moon Shin1, Pyo Nyun Kim1. 1. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea.
Abstract
BACKGROUND: We aimed to determine the value of contrast-enhanced sonography (CEUS) with Sonazoid prior to percutaneous radiofrequency ablation (RFA) of small (<3 cm) hepatocellular carcinoma (HCC). METHODS: This prospective study was approved by our institutional review board and informed consent was obtained. The following criteria were used for study enrollment: (1) cirrhotic patients with HCCs found by contrast-enhanced CT or Gd-EOB-DTPA-enhanced MRI; (2) a single HCC <3 cm in longest diameter or multinodular HCCs (<3) with each tumor <3 cm in longest diameter; and (3) indeterminate identification of the index tumor from the surrounding cirrhosis-related pseudolesions on conventional US. Percutaneous RFA was performed under the guidance of CEUS with Sonazoid. The value of CEUS in index tumor detection and targeting was compared with that of concurrently performed conventional US. RESULTS: A total of 38 patients with 43 HCCs (mean size, 1.6 cm; range, 0.5-2.9 cm) were enrolled. The vascular phase of Sonazoid-enhanced ultrasonography showed good tumor enhancement in 30/43 HCCs (70%). The Kupffer phase increased lesion conspicuity and operator's diagnostic confidence in 29 patients with 31 HCCs (31/43, 72%) compared with conventional US. CONCLUSIONS: CEUS with Sonazoid is useful for detection and targeting of small HCC prior to RFA.
BACKGROUND: We aimed to determine the value of contrast-enhanced sonography (CEUS) with Sonazoid prior to percutaneous radiofrequency ablation (RFA) of small (<3 cm) hepatocellular carcinoma (HCC). METHODS: This prospective study was approved by our institutional review board and informed consent was obtained. The following criteria were used for study enrollment: (1) cirrhotic patients with HCCs found by contrast-enhanced CT or Gd-EOB-DTPA-enhanced MRI; (2) a single HCC <3 cm in longest diameter or multinodular HCCs (<3) with each tumor <3 cm in longest diameter; and (3) indeterminate identification of the index tumor from the surrounding cirrhosis-related pseudolesions on conventional US. Percutaneous RFA was performed under the guidance of CEUS with Sonazoid. The value of CEUS in index tumor detection and targeting was compared with that of concurrently performed conventional US. RESULTS: A total of 38 patients with 43 HCCs (mean size, 1.6 cm; range, 0.5-2.9 cm) were enrolled. The vascular phase of Sonazoid-enhanced ultrasonography showed good tumor enhancement in 30/43 HCCs (70%). The Kupffer phase increased lesion conspicuity and operator's diagnostic confidence in 29 patients with 31 HCCs (31/43, 72%) compared with conventional US. CONCLUSIONS: CEUS with Sonazoid is useful for detection and targeting of small HCC prior to RFA.