title: Contrast-enhanced sonography-guided radiofrequency ablation for the local recurrence of previously treated hepatocellular carcinoma undetected by B-mode sonography.
abstract: BACKGROUND.: The purpose of this study was to assess the usefulness of contrast-enhanced sonography (CEUS) with Sonazoid to demonstrate local recurrence of hepatocellular carcinoma previously treated with radiofrequency ablation (RFA) and not seen on conventional sonography, prior to repeat RFA. METHODS.: This study included 16 cirrhotic patients with 17 cases of hypervascular locally recurrent hepatocellular carcinoma found by contrast-enhanced multidetector row CT (MDCT) but not seen on noncontrast sonography. We used Kupffer-phase imaging and vascular-phase imaging after re-injection. The morphologic patterns of local recurrence detected on CEUS were compared with those on MDCT. We performed repeat RFA guided by CEUS using Kupffer-phase imaging after re-injection. RESULTS.: We were able to detect on CEUS the location of all local recurrences with positive enhancement after re-injection. The morphologic patterns of local recurrence on CEUS were in concordance with those found on MDCT in all lesions. Repeat percutaneous RFA was successfully performed in all lesions. CONCLUSIONS.: The CEUS appearance of local recurrences correlated well with those on MDCT. A wider use of CEUS to guide repeat of percutaneous RFA may be possible with Sonazoid.
authors.affiliation: Department of Radiology, Obihiro Kosei Hospital, 1, W6, S8, Obihiro-shi, Hokkaido 080-0013, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Miyamoto
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Hiramatsu
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Tsuchiya
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Sato
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; D005290:Ferric Compounds; D005500:Follow-Up Studies; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007501:Iron; D008099:Liver / Q000000981:diagnostic imaging*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000601:surgery*; D010087:Oxides; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D003287:Contrast Media; D005290:Ferric Compounds; D010087:Oxides; C069727:Sonazoid; D007501:Iron