title: Value of contrast-enhanced sonography of small hepatocellular carcinoma with sonazoid prior to radiofrequency ablation.
abstract: BACKGROUND
  We aimed to determine the value of contrast-enhanced sonography (CEUS) with Sonazoid prior to percutaneous radiofrequency ablation (RFA) of small (<3 cm) hepatocellular carcinoma (HCC).
  
  
  METHODS
  This prospective study was approved by our institutional review board and informed consent was obtained. The following criteria were used for study enrollment: (1) cirrhotic patients with HCCs found by contrast-enhanced CT or Gd-EOB-DTPA-enhanced MRI; (2) a single HCC <3 cm in longest diameter or multinodular HCCs (<3) with each tumor <3 cm in longest diameter; and (3) indeterminate identification of the index tumor from the surrounding cirrhosis-related pseudolesions on conventional US. Percutaneous RFA was performed under the guidance of CEUS with Sonazoid. The value of CEUS in index tumor detection and targeting was compared with that of concurrently performed conventional US.
  
  
  RESULTS
  A total of 38 patients with 43 HCCs (mean size, 1.6 cm; range, 0.5-2.9 cm) were enrolled. The vascular phase of Sonazoid-enhanced ultrasonography showed good tumor enhancement in 30/43 HCCs (70%). The Kupffer phase increased lesion conspicuity and operator's diagnostic confidence in 29 patients with 31 HCCs (31/43, 72%) compared with conventional US.
  
  
  CONCLUSIONS
  CEUS with Sonazoid is useful for detection and targeting of small HCC prior to RFA. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:383-390, 2017.
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea.
authors.forename: So Jung
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea.
authors.forename: Hyung Jin
authors.identifier: http://orcid.org/0000-0003-3269-0141
authors.initials: HJ
authors.lastname: Won
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea.
authors.forename: Kyung Won
authors.initials: KW
authors.lastname: Kim
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea.
authors.forename: Yong Moon
authors.initials: YM
authors.lastname: Shin
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea.
authors.forename: Pyo Nyun
authors.initials: PN
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D017115:Catheter Ablation; D003287:Contrast Media; D005260:Female; D005290:Ferric Compounds; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007501:Iron; D008099:Liver / Q000601:surgery; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010087:Oxides; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D014463:Ultrasonography / Q000379:methods*
chemical_list: D003287:Contrast Media; D005290:Ferric Compounds; D010087:Oxides; C069727:Sonazoid; D007501:Iron
keywords: contrast-enhanced sonography; hepatocellular carcinoma; liver; radiofrequency ablation