title: Percutaneous radiofrequency ablation of sonographically unidentifiable liver tumors. Feasibility and usefulness of a novel guiding technique with an integrated system of computed tomography and sonographic images.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the safety and feasibility of a real-time integrated system with computed tomography (CT) and sonographic images for radiofrequency (RF) ablation of hepatic malignancies poorly defined on B-mode sonography, and to clarify the suitable phase of CT images for using this virtual sonography.
  
  
  METHODS
  Between September 2004 and December 2004, 12 patients with 16 hepatocellular carcinomas and two metastatic lesions arising from colorectal adenocarcinoma (n = 1) and rectal carcinoid (n = 1) were treated. The maximum diameter of nodules ranged from 1.0 to 2.5 cm (mean +/- SD; 1.5 +/- 0.6 cm) on CT images.
  
  
  RESULTS
  Complete tumor necrosis was achieved in a single session in 19 lesions (90%), while a second session was required for the remaining two lesions (10%). Portal phase multi-planar reconstruction images were displayed under a suitable position corresponding to the ultrasound images in 9 patients (HCC = 7, metastasis = 2), and arterial phase multi-planar reconstruction images were displayed in the 3 remaining patients with hepatocellular carcinoma.
  
  
  CONCLUSIONS
  Percutaneous RF ablation guidance using virtual sonography is an effective treatment for patients with hepatic malignancies. The portal phase of CT images may be the most suitable to indicate the 3-dimensional relationship between the liver vasculature and tumors on virtual sonography.
authors: Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kinki University School of Medicine, Osaka-Sayama, Japan.
authors: Yasunori
authors: Y
authors: Minami
authors: Masatoshi
authors: M
authors: Kudo
authors: Hobyung
authors: H
authors: Chung
authors: Tatsuo
authors: T
authors: Inoue
authors: Shunsuke
authors: S
authors: Takahashi
authors: Kinuyo
authors: K
authors: Hatanaka
authors: Taisuke
authors: T
authors: Ueda
authors: Hitoshi
authors: H
authors: Hagiwara
authors: Satoshi
authors: S
authors: Kitai
authors: Kuzuomi
authors: K
authors: Ueshima
authors: Toyokazu
authors: T
authors: Fukunaga
authors: Hitoshi
authors: H
authors: Shiozaki
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D002276:Carcinoid Tumor / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000601:surgery; D017115:Catheter Ablation / Q000379:methods; D015179:Colorectal Neoplasms / Q000473:pathology; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000295:instrumentation; D014463:Ultrasonography / Q000295:instrumentation