title: Review of dynamic contrast-enhanced ultrasound guidance in ablation therapy for hepatocellular carcinoma.
abstract: Local ablative techniques-percutaneous ethanol injection, microwave coagulation therapy and radiofrequency ablation (RFA)-have been developed to treat unresectable hepatocellular carcinoma (HCC). The success rate of percutaneous ablation therapy for HCC depends on correct targeting of the tumor via an imaging technique. However, probe insertion often is not completely accurate for small HCC nodules, which are poorly defined on conventional B-mode ultrasound (US) alone. Thus, multiple sessions of ablation therapy are frequently required in difficult cases. By means of two breakthroughs in US technology, harmonic imaging and the development of second-generation contrast agents, dynamic contrast-enhanced harmonic US imaging with an intravenous contrast agent can depict tumor vascularity sensitively and accurately, and is able to evaluate small hypervascular HCCs even when B-mode US cannot adequately characterize the tumors. Therefore, dynamic contrast-enhanced US can facilitate RFA electrode placement in hypervascular HCC, which is poorly depicted by B-mode US. The use of dynamic contrast-enhanced US guidance in ablation therapy for liver cancer is an efficient approach. Here, we present an overview of the current status of dynamic contrast-enhanced US-guided ablation therapy, and summarize the current indications and outcomes of reported clinical use in comparison with that of other modalities.
authors.affiliation: Department of Gastroenterology and Hepatology, Kinki University School of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka 589-8511, Japan.
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Minami
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kudo
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D003287:Contrast Media / Q000378:metabolism; D018450:Disease Progression; D005471:Fluoroscopy / Q000379:methods; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D003287:Contrast Media