title: Evaluation of the therapeutic efficacy of high-intensity focused ultrasound ablation of hepatocellular carcinoma by three-dimensional sonography with a perflubutane-based contrast agent.
abstract: OBJECTIVE
  We performed contrast-enhanced three-dimensional sonography (CE 3D US) with a perflubutane-based contrast agent to immediately evaluate the completeness of ablation of small hepatocellular carcinoma (HCC) lesions by extracorporeal high-intensity focused ultrasound (HIFU).
  
  
  METHODS
  Twenty-one HCC lesions were treated by a single ultrasound-guided HIFU ablation session, and CE 3D US was performed before, immediately after, and 1 week, and 1 month after HIFU, and contrast-enhanced CT (CE CT) or contrast-enhanced MRI (CE MRI) was performed before HIFU, 1 week and 1 month after HIFU, and during the follow-up period.
  
  
  RESULTS
  Immediately and 1 month after HIFU, 17 lesions were evaluated as adequately ablated by CE 3D US, and the other 4 lesions as residual tumors. One month after HIFU, 18 were evaluated as adequately ablated by CE CT or CE MRI, and the other 3 as residual tumors. The evaluation by CE 3D US immediately after HIFU and by CE CT or CE MRI 1 month after HIFU was concordant with 20 lesions. The kappa value for agreement between the findings of CE 3D US and other modalities by two blinded observers was 0.83. When the 1-month CE CT or CE MRI findings were used as the reference standard, the sensitivity, specificity, and accuracy of CE 3D US immediately after HIFU for the diagnosis of the adequate ablation were 100%, 75%, and 95%, respectively.
  
  
  CONCLUSIONS
  CE 3D US appears to be a useful method for immediate evaluation of therapeutic efficacy of HIFU ablation of HCC lesions.
authors.affiliation: Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa 232-0024, Japan. kz-numa@urahp.yokohama-cu.ac.jp
authors.forename: Kazushi
authors.initials: K
authors.lastname: Numata
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Fukuda
authors.forename: Masao
authors.initials: M
authors.lastname: Ohto
authors.forename: Ryu
authors.initials: R
authors.lastname: Itou
authors.forename: Akito
authors.initials: A
authors.lastname: Nozaki
authors.forename: Masaaki
authors.initials: M
authors.lastname: Kondou
authors.forename: Manabu
authors.initials: M
authors.lastname: Morimoto
authors.forename: Eii
authors.initials: E
authors.lastname: Karasawa
authors.forename: Katsuaki
authors.initials: K
authors.lastname: Tanaka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000628:therapy*; D003287:Contrast Media; D005260:Female; D005290:Ferric Compounds; D005466:Fluorocarbons; D057086:High-Intensity Focused Ultrasound Ablation; D006801:Humans; D021621:Imaging, Three-Dimensional; D007501:Iron; D008113:Liver Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D010087:Oxides; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional
chemical_list: D003287:Contrast Media; D005290:Ferric Compounds; D005466:Fluorocarbons; D010087:Oxides; C069727:Sonazoid; D007501:Iron; C108042:perfluorobutane