title: Combination guidance of contrast-enhanced US and fusion imaging in radiofrequency ablation for hepatocellular carcinoma with poor conspicuity on contrast-enhanced US/fusion imaging.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the usefulness of the combination guidance of contrast-enhanced US (CEUS) and fusion imaging in radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) with poor conspicuity on B-mode US and CEUS/fusion imaging.
  
  
  METHODS
  We conducted a retrospective cohort study, which included 356 patients with 556 HCCs that were inconspicuous on B-mode US. A total of 192 patients with 344 HCCs, 123 patients with 155 HCCs, and 37 patients with 57 HCCs underwent RFA under CEUS guidance, fusion imaging guidance, and the combination of CEUS and fusion imaging guidance.
  
  
  RESULTS
  The average number of treatment sessions was 1.1 (range: 1-2) in the CEUS guidance group, 1.1 (range: 1-2) in the fusion imaging guidance group, and 1.1 (range: 1-3) in the combination of CEUS and fusion imaging guidance group. Treatment analysis did not reveal significantly more RFA treatment sessions in the combination guidance group than in the other groups (p = 0.97, Student's t test). During the follow-up period (1.1-85.3 months, mean ± SD, 43.2 ± 59.5), the 3-year local tumor progression rates were 4.9, 7.2, and 5.9% in the CEUS guidance group, the fusion imaging guidance group, and the combination guidance group, respectively (p = 0.84, log-rank test).
  
  
  CONCLUSIONS
  In spite of selection bias, session frequency and local tumor progression were not different under the combination guidance with CEUS and fusion imaging in RFA. The combination of fusion imaging and CEUS guidance in RFA therapy is an effective treatment for HCC with poor conspicuity on B-mode US and CEUS/fusion imaging.
authors.affiliation: Department of Gastroenterology and Hepatology, Kinki University School of Medicine, Osaka-Sayama, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Minami
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Minami
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Chishina
authors.forename: Tadaaki
authors.initials: T
authors.lastname: Arizumi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Takita
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kitai
authors.forename: Norihisa
authors.initials: N
authors.lastname: Yada
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Inoue
authors.forename: Satoru
authors.initials: S
authors.lastname: Hagiwara
authors.forename: Kazuomi
authors.initials: K
authors.lastname: Ueshima
authors.forename: Naoshi
authors.initials: N
authors.lastname: Nishida
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kudo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods; D003287:Contrast Media; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional / Q000379:methods*
chemical_list: D003287:Contrast Media