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Contrast Harmonic Sonography-Guided Radiofrequency Ablation Therapy Versus B-Mode Sonography in Hepatocellular Carcinoma: Prospective Randomized Controlled Trial

Yasunori Minami1, Masatoshi Kudo1, Hobyung Chung1, Toshihiko Kawasaki1, Yukinobu Yagyu2, Taro Shimono2 and Hitoshi Shiozaki3

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


Figure 1
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  		Fig. 1A —71-year-old man with 2.0-cm local progression of hepatocellular carcinoma after intraoperative radiofrequency ablation therapy for large hepatocellular carcinoma in right hepatic lobe. Early-phase dynamic CT scan shows outgrowth pattern of locally progressive hepatocellular carcinoma (arrow) in right hepatic lobe. Lesion borders on unenhanced area, which was previously treated.

 

Figure 2
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  		Fig. 1B —71-year-old man with 2.0-cm local progression of hepatocellular carcinoma after intraoperative radiofrequency ablation therapy for large hepatocellular carcinoma in right hepatic lobe. Contrast harmonic sonogram shows enhancement of viable focus of hepatocellular carcinoma (arrow).

 

Figure 3
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  		Fig. 1C —71-year-old man with 2.0-cm local progression of hepatocellular carcinoma after intraoperative radiofrequency ablation therapy for large hepatocellular carcinoma in right hepatic lobe. Contrast harmonic sonogram shows radiofrequency electrode needle (arrows) inserted into viable focus of hepatocellular carcinoma.

 

Figure 4
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  		Fig. 1D —71-year-old man with 2.0-cm local progression of hepatocellular carcinoma after intraoperative radiofrequency ablation therapy for large hepatocellular carcinoma in right hepatic lobe. Early-phase dynamic CT scan obtained 2 days after radiofrequency ablation therapy shows tumor and surrounding area are not enhanced, indicating complete necrosis.

 

Figure 5
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  		Fig. 2A —69-year-old man with 1.5-cm local tumor progression of hepatocellular carcinoma after percutaneous radiofrequency ablation in segment VIII of liver. Early-phase dynamic CT scan shows outgrowth pattern of local tumor progression of hepatocellular carcinoma as enhanced lesion (arrow) between unenhanced warped area, which was previously treated.

 

Figure 6
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  		Fig. 2B —69-year-old man with 1.5-cm local tumor progression of hepatocellular carcinoma after percutaneous radiofrequency ablation in segment VIII of liver. Contrast harmonic sonogram shows enhancement of viable focus of hepatocellular carcinoma (arrow).

 

Figure 7
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  		Fig. 2C —69-year-old man with 1.5-cm local tumor progression of hepatocellular carcinoma after percutaneous radiofrequency ablation in segment VIII of liver. Contrast harmonic sonogram shows radiofrequency electrode needle (arrows) inserted into viable hepatocellular carcinoma.

 

Figure 8
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  		Fig. 2D —69-year-old man with 1.5-cm local tumor progression of hepatocellular carcinoma after percutaneous radiofrequency ablation in segment VIII of liver. Early-phase dynamic CT scan obtained 3 days after radiofrequency ablation therapy shows tumor and surrounding area are not enhanced.

 

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