title: Effectiveness of real-time virtual sonography-guided radiofrequency ablation treatment for patients with hepatocellular carcinomas.
abstract: OBJECTIVE
  Real-time virtual sonography (RVS) can synchronize B-mode ultrasound (US) images with multiplanar reconstruction (MPR)-computed tomography (CT) images on the same screen in real time. The purpose of this study was to evaluate the effectiveness of RVS for radiofrequency ablation therapy (RFA) of hepatocellular carcinomas (HCC) in which it was difficult to identify contours or margins by B-mode US.
  
  
  METHODS
  Sixty-three consecutive patients with a solitary HCC of less than 3.5 cm in diameter were enrolled in this study. Thirty-nine patients with HCC clearly detectable by B-mode US underwent conventional RFA, while the remaining 24 with obscure tumor lesions underwent RVS-guided RFA. A follow-up study of RFA treatment was performed every 3 months using enhanced CT imaging of the arterial and portal phase (at least 24 months). The accuracy of needle insertion was confirmed by measuring the gap between the needle insertion line and the center of the tumor from MPR-CT images.
  
  
  RESULTS
  The local recurrence rate of the RVS-guided RFA group was similar to that of the conventional RFA group (8.3% vs 7.7%), despite the difficulty of detecting tumor lesions in the former group. The mean gap between the needle insertion line and the center of the tumor was 1.6 mm (0-3.2 mm) in eight patients treated with RVS-guided RFA.
  
  
  CONCLUSIONS
  RVS-guided RFA can be useful for treating HCC that are difficult to detect by B-mode US.
authors.affiliation: Department of Gastroenterology and Hepatology, Itami City Hospital, Itami, Japan.
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Kitada
authors.forename: Takamichi
authors.initials: T
authors.lastname: Murakami
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Kuzushita
authors.forename: Kaori
authors.initials: K
authors.lastname: Minamitani
authors.forename: Kazuya
authors.initials: K
authors.lastname: Nakajo
authors.forename: Keigo
authors.initials: K
authors.lastname: Osuga
authors.forename: Eiji
authors.initials: E
authors.lastname: Miyoshi
authors.forename: Hironobu
authors.initials: H
authors.lastname: Nakamura
authors.forename: Bunichiro
authors.initials: B
authors.lastname: Kishino
authors.forename: Shinji
authors.initials: S
authors.lastname: Tamura
authors.forename: Norio
authors.initials: N
authors.lastname: Hayashi