title: Virtual sonographic radiofrequency ablation of hepatocellular carcinoma visualized on CT but not on conventional sonography.
abstract: OBJECTIVE
  Some nodules cannot be visualized clearly on conventional sonography but can be visualized on CT. In the present study, we evaluated the usefulness of real-time percutaneous ablation therapy under virtual sonographic guidance for these nodules.
  
  
  METHODS
  In vitro experiments were performed with gelatin gel to evaluate the accuracy of virtual sonography. We also studied 50 patients with 58 hepatocellular carcinoma nodules, of whom 18 patients (21 nodules) underwent radiofrequency ablation by virtual sonography. This was the initial treatment for seven of these patients and an additional treatment for 11 patients. Thirty-two patients (37 nodules) received radiofrequency ablation without virtual imaging. The patients receiving standard radiofrequency ablation were retrospectively selected as the historical control group under the same conditions as the study group.
  
  
  RESULTS
  The in vitro gelatin gel study revealed that all punctures had been performed accurately. In both the initial-treatment group and the additional-treatment group, the mean number of treatments with virtual sonography was significantly lower than that without virtual sonography (p = 0.003 for both groups). The rates of local recurrence and complications did not differ significantly between the two groups.
  
  
  CONCLUSIONS
  In the treatment of nodules not depicted on sonography, radiofrequency ablation assisted by virtual sonography is an efficacious alternative.
authors.affiliation: Third Department of Internal Medicine, Ehime University, Sigenobutyo Sizukawa, Ehime, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Hirooka
authors.forename: Hidehito
authors.initials: H
authors.lastname: Iuchi
authors.forename: Teru
authors.initials: T
authors.lastname: Kumagi
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Shigematsu
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hiraoka
authors.forename: Takahide
authors.initials: T
authors.lastname: Uehara
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Kurose
authors.forename: Norio
authors.initials: N
authors.lastname: Horiike
authors.forename: Morikazu
authors.initials: M
authors.lastname: Onji
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000601:surgery; D017115:Catheter Ablation; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography