title: Radiofrequency ablation assisted by real-time virtual sonography and CT for hepatocellular carcinoma undetectable by conventional sonography.
abstract: Real-time virtual sonography (RVS) is a diagnostic imaging support system, which provides the same cross-sectional multiplanar reconstruction images as ultrasound images on the same monitor screen in real time. The purpose of this study was to evaluate radiofrequency ablation (RFA) assisted by RVS and CT for hepatocellular carcinoma (HCC) undetectable with conventional sonography. Subjects were 20 patients with 20 HCC nodules not detected by conventional sonography but detectable by CT or MRI. All patients had hepatitis C-induced liver cirrhosis; there were 13 males and 7 females aged 55-81 years (mean, 69.3 years). RFA was performed in the CT room, and the tumor was punctured with the assistance of RVS. CT was performed immediately after puncture, and ablation was performed after confirming that the needle had been inserted into the tumor precisely. The mean number of punctures and success rates of the first puncture were evaluated. Treatment effects were evaluated with dynamic CT every 3 months after RFA. RFA was technically feasible and local tumor control was achieved in all patients. The mean number of punctures was 1.1, and the success rate of the first puncture was 90.0%. This method enabled safe ablation without complications. The mean follow-up period was 13.5 month (range, 9-18 months). No local recurrence was observed at the follow-up points. In conclusion, RFA assisted by RVS and CT is a safe and efficacious method of treatment for HCC undetectable by conventional sonography.
authors.affiliation: Department of Radiology, Wakayama Medical University, Wakayama-shi, Wakayama, Japan. momonga@wakayama-med.ac.jp
authors.forename: Motoki
authors.initials: M
authors.lastname: Nakai
authors.forename: Morio
authors.initials: M
authors.lastname: Sato
authors.forename: Shinya
authors.initials: S
authors.lastname: Sahara
authors.forename: Isao
authors.initials: I
authors.lastname: Takasaka
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Kawai
authors.forename: Hiroki
authors.initials: H
authors.lastname: Minamiguchi
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Tanihata
authors.forename: Masashi
authors.initials: M
authors.lastname: Kimura
authors.forename: Nozomu
authors.initials: N
authors.lastname: Takeuchi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D003287:Contrast Media; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D003287:Contrast Media