Percutaneous ablation therapy guided by contrast-enhanced sonography for patients with hepatocellular carcinoma.
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.
Numata
Kazushi
K
Clinical Laboratory, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.
Isozaki
Tetsuo
T
Ozawa
Yutaka
Y
Sakaguchi
Takashi
T
Kiba
Takayoshi
T
Kubota
Toru
T
Ito
Akira
A
Sugimori
Kazuya
K
Shirato
Kazuhito
K
Morimoto
Manabu
M
Tanaka
Katsuaki
K
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
D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508; D000431:Ethanol