title: Mistargeting after fusion imaging-guided percutaneous radiofrequency ablation of hepatocellular carcinomas.
abstract: OBJECTIVE
  To evaluate the incidence and causes of mistargeting after fusion imaging-guided percutaneous radiofrequency (RF) ablation of hepatocellular carcinomas (HCCs).
  
  
  METHODS
  Between September 2011 and March 2013, 955 HCCs in 732 patients were treated with percutaneous RF ablation. Among them, ablation of 551 HCCs was accomplished under fusion imaging guidance, and seven mistargetings were noted in seven patients (male-to-female ratio = 6:1; mean age, 60.1 y; range, 47-73 y). The incidence of mistargeting and the cause of liver disease in the patients with mistargeting were evaluated. The causes of mistargeting were assessed according to the following classification: small size of HCC, subcapsular location, subphrenic location, confusion with pseudolesions, poor conspicuity of HCC, poor sonographic window, and poor electrode path.
  
  
  RESULTS
  The incidence of mistargeting after fusion imaging-guided RF ablation was 1.3% (7 of 551). All patients with mistargeting were hepatitis B virus carriers. The most common cause of mistargeting was the small size of HCC (100%; 7 of 7), followed by confusion with surrounding pseudolesions (85.7%; 6 of 7), subcapsular (71.4%; 5 of 7) and subphrenic locations (71.4%; 5 of 7), poor conspicuity of the HCC (71.4%; 6 of 7), poor sonographic window (28.6%; 2 of 7), and poor electrode path (28.6%; 2 of 7).
  
  
  CONCLUSIONS
  The incidence of mistargeting after fusion imaging-guided RF ablation was 1.3%. The most common cause of mistargeting was the small size of HCC, followed by confusion with surrounding pseudolesions, subcapsular and subphrenic locations, and poor conspicuity of the HCC.
authors: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Republic of Korea.
authors: Sanghyeok
authors: S
authors: Lim
authors: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Republic of Korea. Electronic address: leeminwoo0@gmail.com.
authors: Min Woo
authors: MW
authors: Lee
authors: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Republic of Korea.
authors: Hyunchul
authors: H
authors: Rhim
authors: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Republic of Korea.
authors: Dong Ik
authors: DI
authors: Cha
authors: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Republic of Korea.
authors: Tae Wook
authors: TW
authors: Kang
authors: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Republic of Korea.
authors: Ji Hye
authors: JH
authors: Min
authors: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Republic of Korea.
authors: Kyoung Doo
authors: KD
authors: Song
authors: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Republic of Korea.
authors: Seo-Youn
authors: SY
authors: Choi
authors: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Republic of Korea.
authors: Hyo K
authors: HK
authors: Lim
mesh_terms: D000368:Aged; D059925:Anatomic Landmarks; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D053783:Magnetic Resonance Imaging, Interventional; D008297:Male; D019300:Medical Errors; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D064847:Multimodal Imaging / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology*; D011237:Predictive Value of Tests; D015641:Radiography, Interventional; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D047368:Tumor Burden; D018084:Ultrasonography, Interventional
keywords: HCC; hepatocellular carcinoma