Effectiveness of real-time virtual sonography-guided radiofrequency ablation treatment for patients with hepatocellular carcinomas.
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.
Kitada
Takatoshi
T
Department of Gastroenterology and Hepatology, Itami City Hospital, Itami, Japan.
Murakami
Takamichi
T
Kuzushita
Noriyoshi
N
Minamitani
Kaori
K
Nakajo
Kazuya
K
Osuga
Keigo
K
Miyoshi
Eiji
E
Nakamura
Hironobu
H
Kishino
Bunichiro
B
Tamura
Shinji
S
Hayashi
Norio
N