Iranian Journal of Radiology

Published by: Kowsar

Added Value of Contrast-Enhanced Ultrasonography as a Planning Modality for Radiofrequency Ablation of Hepatocellular Carcinoma: Comparison with Gray-Scale Ultrasonography

So Hee Kim 1 , Jae Woong Choi 1 , * , Yang Shin Park 1 , Jongmee Lee 1 , Chang Hee Lee 1 , Kyeong Ah Kim 1 , Min Ju Kim 2 and Cheol Min Park 1
Authors Information
1 Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea
2 Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea
Article information
  • Iranian Journal of Radiology: April 2017, 14 (2); e43232
  • Published Online: December 24, 2016
  • Article Type: Research Article
  • Received: October 26, 2016
  • Revised: November 14, 2016
  • Accepted: December 7, 2016
  • DOI: 10.5812/iranjradiol.43232

To Cite: Kim S H, Choi J W, Park Y S, Lee J, Lee C H, et al. Added Value of Contrast-Enhanced Ultrasonography as a Planning Modality for Radiofrequency Ablation of Hepatocellular Carcinoma: Comparison with Gray-Scale Ultrasonography, Iran J Radiol. 2017 ; 14(2):e43232. doi: 10.5812/iranjradiol.43232.

Copyright © 2016, Tehran University of Medical Sciences and Iranian Society of Radiology. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Background
2. Objectives
3. Patients and Methods
4. Results
5. Discussion
  • 1. Strobel D, Seitz K, Blank W, Schuler A, Dietrich CF, von Herbay A, et al. Tumor-specific vascularization pattern of liver metastasis, hepatocellular carcinoma, hemangioma and focal nodular hyperplasia in the differential diagnosis of 1,349 liver lesions in contrast-enhanced ultrasound (CEUS). Ultraschall Med. 2009; 30(4): 376-82[DOI][PubMed]
  • 2. Leen E, Ceccotti P, Kalogeropoulou C, Angerson WJ, Moug SJ, Horgan PG. Prospective multicenter trial evaluating a novel method of characterizing focal liver lesions using contrast-enhanced sonography. AJR Am J Roentgenol. 2006; 186(6): 1551-9[DOI][PubMed]
  • 3. Quaia E, Stacul F, Gaiani S, Ricci P, Passariello R, Curzio D, et al. Comparison of diagnostic performance of unenhanced vs SonoVue - enhanced ultrasonography in focal liver lesions characterization. The experience of three Italian centers. Radiol Med. 2004; 108(1-2): 71-81[PubMed]
  • 4. Tateishi R, Shiina S, Teratani T, Obi S, Sato S, Koike Y, et al. Percutaneous radiofrequency ablation for hepatocellular carcinoma. An analysis of 1000 cases. Cancer. 2005; 103(6): 1201-9[DOI][PubMed]
  • 5. Feng K, Yan J, Li X, Xia F, Ma K, Wang S, et al. A randomized controlled trial of radiofrequency ablation and surgical resection in the treatment of small hepatocellular carcinoma. J Hepatol. 2012; 57(4): 794-802[DOI][PubMed]
  • 6. Lau WY, Lai EC. Hepatocellular carcinoma: current management and recent advances. Hepatobiliary Pancreat Dis Int. 2008; 7(3): 237-57[PubMed]
  • 7. Strobel D, Seitz K, Blank W, Schuler A, Dietrich C, von Herbay A, et al. Contrast-enhanced ultrasound for the characterization of focal liver lesions--diagnostic accuracy in clinical practice (DEGUM multicenter trial). Ultraschall Med. 2008; 29(5): 499-505[DOI][PubMed]
  • 8. Kim PN, Choi D, Rhim H, Rha SE, Hong HP, Lee J, et al. Planning ultrasound for percutaneous radiofrequency ablation to treat small (</= 3 cm) hepatocellular carcinomas detected on computed tomography or magnetic resonance imaging: a multicenter prospective study to assess factors affecting ultrasound visibility. J Vasc Interv Radiol. 2012; 23(5): 627-34[DOI][PubMed]
  • 9. European Association For The Study Of The L, European Organisation For R, Treatment Of C. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol. 2012; 56(4): 908-43[DOI][PubMed]
  • 10. Bruix J, Sherman M, Practice Guidelines Committee AAFTSOLD. Management of hepatocellular carcinoma. Hepatology. 2005; 42(5): 1208-36[DOI][PubMed]
  • 11. Claudon M, Dietrich CF, Choi BI, Cosgrove DO, Kudo M, Nolsoe CP, et al. Guidelines and good clinical practice recommendations for Contrast Enhanced Ultrasound (CEUS) in the liver - update 2012: A WFUMB-EFSUMB initiative in cooperation with representatives of AFSUMB, AIUM, ASUM, FLAUS and ICUS. Ultrasound Med Biol. 2013; 39(2): 187-210[DOI][PubMed]
  • 12. Bruix J, Sherman M, Llovet JM, Beaugrand M, Lencioni R, Burroughs AK, et al. Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL conference. European Association for the Study of the Liver. J Hepatol. 2001; 35(3): 421-30[PubMed]
  • 13. Llovet JM, Burroughs A, Bruix J. Hepatocellular carcinoma. Lancet. 2003; 362(9399): 1907-17[DOI][PubMed]
  • 14. Spangenberg HC, Thimme R, Blum HE. Evolving therapies in the treatment of hepatocellular carcinoma. Biologics. 2008; 2(3): 453-62[PubMed]
  • 15. Minami Y, Kudo M. Radiofrequency ablation of hepatocellular carcinoma: Current status. World J Radiol. 2010; 2(11): 417-24[DOI][PubMed]
  • 16. Chen MS, Li JQ, Zheng Y, Guo RP, Liang HH, Zhang YQ, et al. A prospective randomized trial comparing percutaneous local ablative therapy and partial hepatectomy for small hepatocellular carcinoma. Ann Surg. 2006; 243(3): 321-8[DOI][PubMed]
  • 17. Kudo M. Radiofrequency ablation for hepatocellular carcinoma: updated review in 2010. Oncology. 2010; 78 Suppl 1: 113-24[DOI][PubMed]
  • 18. Albrecht T, Blomley M, Bolondi L, Claudon M, Correas JM, Cosgrove D, et al. Guidelines for the use of contrast agents in ultrasound. January 2004. Ultraschall Med. 2004; 25(4): 249-56[DOI][PubMed]
  • 19. Makino Y, Imai Y, Ohama H, Igura T, Kogita S, Sawai Y, et al. Ultrasonography fusion imaging system increases the chance of radiofrequency ablation for hepatocellular carcinoma with poor conspicuity on conventional ultrasonography. Oncology. 2013; 84 Suppl 1: 44-50[DOI][PubMed]
  • 20. Hatanaka K, Kudo M, Minami Y, Maekawa K. Sonazoid-enhanced ultrasonography for diagnosis of hepatic malignancies: comparison with contrast-enhanced CT. Oncology. 2008; 75 Suppl 1: 42-7[DOI][PubMed]
  • 21. Maruyama H, Kobayashi S, Yoshizumi H, Okugawa H, Akiike T, Yukisawa S, et al. Application of percutaneous ultrasound-guided treatment for ultrasonically invisible hypervascular hepatocellular carcinoma using microbubble contrast agent. Clin Radiol. 2007; 62(7): 668-75[DOI][PubMed]
  • 22. Numata K, Morimoto M, Ogura T, Sugimori K, Takebayashi S, Okada M, et al. Ablation therapy guided by contrast-enhanced sonography with Sonazoid for hepatocellular carcinoma lesions not detected by conventional sonography. J Ultrasound Med. 2008; 27(3): 395-406[PubMed]
  • 23. Chan AK, Hegarty C, Klass D, Yoshida E, Chung S, Liu DM, et al. The Role of Contrast-enhanced Ultrasound in Guiding Radiofrequency Ablation of Hepatocellular Carcinoma: A Retrospective Study. Can Assoc Radiol J. 2015; 66(2): 171-8[DOI][PubMed]
  • 24. Takayasu K, Muramatsu Y, Asai S, Muramatsu Y, Kobayashi T. CT fluoroscopy-assisted needle puncture and ethanol injection for hepatocellular carcinoma: a preliminary study. AJR Am J Roentgenol. 1999; 173(5): 1219-24[DOI][PubMed]
  • 25. Nakai M, Sato M, Sahara S, Takasaka I, Kawai N, Minamiguchi H, et al. Radiofrequency ablation assisted by real-time virtual sonography and CT for hepatocellular carcinoma undetectable by conventional sonography. Cardiovasc Intervent Radiol. 2009; 32(1): 62-9[DOI][PubMed]
  • 26. Kitada T, Murakami T, Kuzushita N, Minamitani K, Nakajo K, Osuga K, et al. Effectiveness of real-time virtual sonography-guided radiofrequency ablation treatment for patients with hepatocellular carcinomas. Hepatol Res. 2008; 38(6): 565-71[DOI][PubMed]
  • 27. Minami Y, Kudo M, Chung H, Inoue T, Takahashi S, Hatanaka K, et al. Percutaneous radiofrequency ablation of sonographically unidentifiable liver tumors. Feasibility and usefulness of a novel guiding technique with an integrated system of computed tomography and sonographic images. Oncology. 2007; 72 Suppl 1: 111-6[DOI][PubMed]
  • 28. Kudo K, Moriyasu F, Mine Y, Miyata Y, Sugimoto K, Metoki R, et al. Preoperative RFA simulation for liver cancer using a CT virtual ultrasound system. Eur J Radiol. 2007; 61(2): 324-31[DOI][PubMed]
  • 29. Toshikuni N, Takuma Y, Tomokuni J, Yamamoto H. Planning Sonography Using Real-time Virtual Sonography and Contrast-enhanced Sonography for Radiofrequency Ablation of Inconspicuous Hepatocellular Carcinoma Nodules. Hepatogastroenterology. 2015; 62(139): 661-6[PubMed]
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