title: Percutaneous radiofrequency ablation of hepatocellular carcinoma: fusion imaging guidance for management of lesions with poor conspicuity at conventional sonography.
abstract: OBJECTIVE
  The purpose of this study was to determine whether fusion imaging-guided percutaneous radiofrequency ablation (RFA) is effective in the management of hepatocellular carcinoma (HCC) that has poor conspicuity at conventional sonography.
  
  
  METHODS
  Percutaneous RFA of HCC with poor conspicuity was performed under fusion imaging guidance. The time needed for image fusion between the ultrasound and CT or MR images was recorded. The quality of image fusion and the degree of operator confidence in identifying the index tumor were graded on 4-point scales. Technical success and procedure-related complications were evaluated with liver CT immediately after RFA.
  
  
  RESULTS
  Thirty patients with HCC (1.0 ± 0.3 cm) were enrolled. Twenty-seven of the 30 lesions detected at planning ultrasound were identified with fusion imaging. Of the 30 HCC candidate lesions detected with ultrasound, five were found to be pseudolesions close to the index tumor. The time needed for image fusion for the 27 lesions was 3.7 ± 2.1 minutes (range, 1.3-9.0 minutes). The quality of image fusion was graded 3.4 ± 0.6, and the degree of operator confidence in identifying the 30 HCCs, 3.3 ± 0.9. The technical success rate was 90% (27/30) in intention-to-treat analysis and 100% in analysis of actually treated lesions. There were no major RFA-related complications.
  
  
  CONCLUSIONS
  Fusion imaging-guided percutaneous RFA is effective in the management of HCC that has poor ultrasound conspicuity.
authors.affiliation: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Min Woo
authors.initials: MW
authors.lastname: Lee
authors.forename: Hyunchul
authors.initials: H
authors.lastname: Rhim
authors.forename: Dong Ik
authors.initials: DI
authors.lastname: Cha
authors.forename: Young Jun
authors.initials: YJ
authors.lastname: Kim
authors.forename: Dongil
authors.initials: D
authors.lastname: Choi
authors.forename: Young-sun
authors.initials: YS
authors.lastname: Kim
authors.forename: Hyo K
authors.initials: HK
authors.lastname: Lim
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D003287:Contrast Media; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D007472:Iohexol / Q000031:analogs & derivatives; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D003287:Contrast Media; D007472:Iohexol; C038192:iopromide