Role of Sonazoid-enhanced three-dimensional ultrasonography in the evaluation of percutaneous radiofrequency ablation of hepatocellular carcinoma.
OBJECTIVE
We investigated contrast-enhanced three-dimensional ultrasonography (CE 3D US) with contrast agent Sonazoid for evaluating the effect of percutaneous radiofrequency (RF) ablation of hepatocellular carcinomas (HCCs).


METHODS
63 HCCs were treated by US-guided percutaneous RF ablation. CE 3D US after bolus injection of 0.2 mL of Sonazoid was performed 5-7 days before and 1 day after RF ablation. CE 3D computed tomography (CT) was performed 5-7 days before and 1 month after the ablation, and during the follow-up period. Multiplanar images in three orthogonal planes and US/CT angiograms were reconstructed on both modalities. Two blinded observers reviewed the images on both modalities to evaluate the ablation effects.


RESULTS
After RF ablation, the evaluation on CE 3D US and that on CE 3D CT achieved concordance in 61 lesions. Among them, 59 lesions were detected with the absence of tumor vessels and tumor enhancement and evaluated as adequate ablation, and the remaining two lesions were detected with residual tumors. The kappa value for agreement between the findings on the two modalities was 0.65. When 1-month CE 3D CT scans were used as reference standard, the sensitivity, specificity, and accuracy of 1-day CE 3D US for detecting adequate ablation were 97%, 100%, and 97%, respectively.


CONCLUSIONS
By demonstrating the ablated areas and residual tumors in three dimensions, CE 3D US with Sonazoid was shown to be useful for evaluating the effect of RF ablation of HCCs, and there was good concordance with the results obtained by CE 3D CT.
Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan.
Wen
W
Luo
Kazushi
K
Numata
Manabu
M
Morimoto
Takashi
T
Oshima
Michio
M
Ueda
Masahiro
M
Okada
Shigeo
S
Takebayashi
Xiaodong
X
Zhou
Katsuaki
K
Tanaka
D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging*; D017115:Catheter Ablation / Q000379:methods*; D003287:Contrast Media; D005260:Female; D005290:Ferric Compounds; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007501:Iron; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010087:Oxides; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014463:Ultrasonography / Q000379:methods*
D003287:Contrast Media; D005290:Ferric Compounds; D010087:Oxides; C069727:Sonazoid; D007501:Iron