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Treatment of Hepatocellular Carcinoma with Percutaneous Radiofrequency Ablation: Usefulness of Contrast Harmonic Sonography for Lesions Poorly Defined with B-Mode Sonography

¹ Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kinki University School of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama 589-8511, Japan.
² Department of Surgery, Kinki University School of Medicine, Osaka-Sayama 589-8511, Japan.

OBJECTIVE. The purpose of this study was to assess the usefulness of contrast harmonic sonography guidance in percutaneous radiofrequency ablation of hepatocellular carcinomas that could not be adequately depicted by B-mode sonography.

SUBJECTS AND METHODS. Twenty-one patients with 21 hepatocellular carcinomas prospectively underwent radiofrequency ablation treatment with contrast harmonic sonography as guidance. Twenty-five patients with 25 hepatocellular carcinomas were retrospectively selected as the historical control group under the same conditions as the study group; the control group patients were treated under B-mode sonography guidance.

RESULTS. Twenty (95.2%) of the 21 patients were successfully treated during a single treatment session, and the remaining patient (4.8%) required two treatment sessions with contrast harmonic guidance. On the other hand, only eight (32%) of the 25 control subjects were successfully treated during a single treatment session using B-mode sonographic guidance without contrast imaging. The difference between these two groups was statistically significant (p = 0.002).

CONCLUSION. Contrast harmonic sonography helps in the placement of radiofrequency ablation electrodes in hypervascular hepatocellular carcinomas that cannot be adequately depicted by B-mode sonography.

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