title: Percutaneous ablation therapy guided by contrast-enhanced sonography for patients with hepatocellular carcinoma.
abstract: OBJECTIVE
  The newly developed contrast-enhanced harmonic gray-scale sonography technique enables us to improve the real-time detectability of viable tumor tissue in hepatocellular carcinoma lesions. We evaluated the usefulness of real-time percutaneous ablation therapy under guidance with this method for patients with hepatocellular carcinoma that is not depicted on conventional sonography.
  
  
  METHODS
  We examined 30 patients with 56 hepatocellular carcinomas using real-time contrast-enhanced harmonic gray-scale sonography after injection of a galactose-palmitic acid contrast agent and compared the results with the findings of contrast-enhanced helical CT. We performed percutaneous ablation therapy guided by this modality for treatment of viable hepatocellular carcinoma lesions that could not be detected using conventional sonography.
  
  
  RESULTS
  High detection rates of viable hepatocellular carcinoma lesions were obtained using real-time contrast-enhanced harmonic gray-scale sonography (52/56 lesions, 93%); these rates were comparable to those of helical CT (54/56 lesions, 96%). Nine (90%) of the 10 lesions that were not detected on conventional sonography but were depicted on real-time contrast-enhanced harmonic gray-scale sonography (incomplete local treatment, n = 4; small new lesion, n = 6) were successfully treated with percutaneous ablation therapy guided by this method.
  
  
  CONCLUSIONS
  Real-time contrast-enhanced harmonic gray-scale sonography improved the sensitivity for the detection of viable hepatocellular carcinoma lesions. Percutaneous ablation therapy guided by this modality may be useful in patients with hypervascular hepatocellular carcinoma lesions that cannot be detected using conventional sonography.
authors.affiliation: Clinical Laboratory, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.
authors.forename: Kazushi
authors.initials: K
authors.lastname: Numata
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Isozaki
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Ozawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Sakaguchi
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Kiba
authors.forename: Toru
authors.initials: T
authors.lastname: Kubota
authors.forename: Akira
authors.initials: A
authors.lastname: Ito
authors.forename: Kazuya
authors.initials: K
authors.lastname: Sugimori
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Shirato
authors.forename: Manabu
authors.initials: M
authors.lastname: Morimoto
authors.forename: Katsuaki
authors.initials: K
authors.lastname: Tanaka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000628:therapy; D017115:Catheter Ablation; D003287:Contrast Media; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007267:Injections; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011134:Polysaccharides; D036542:Tomography, Spiral Computed; D018084:Ultrasonography, Interventional
chemical_list: D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508; D000431:Ethanol