Objective: To investigate the clinical value of enhanced ultrasonography before and after ultrasound guided radiofrequency ablation (RFA) of hepatomas.
Methods: Eighteen patients with 17 primary hepatocellular carcinoma and 1 hepatic metastasis were studied. Sixteen were confirmed by operation or needle puncture biopsy, 2 by clinical examinations including CT scanning, MRI etc. New contrast agent, SonoVue, Technos DU6 and Contrast Tuned Imaging (CnTI) technique were adopted. Enhanced ultrasonography was performed before or after the RFA procedure.
Results: Twenty-six lesions were observed with enhanced ultrasonography before RFA, 24 of which showed ball-carrying sign or diffuse enhancement at the early artery phase favoring the fast diagnosis; 9 lesions showed feeding vessels; twelve of the 26 lesions (46.2%) tended to be larger, especially those with unclear margins (78.6%, 11/14) and those without halo sign (68.8%, 11/16). Enhanced ultrasonography revealed 13 satellite foci in four cases which had been undetectable with routine ultrasound, CT scanning or MRI. The final diagnosis of either inactivation or residual disease would rely upon more than two kinds of images, levels of tumor marks, biopsy pathology and more than 7 months of follow-up. Twenty-two lesions were observed with enhanced ultrasonography after RFA, with an accuracy of 95.5% (21/22), being similar to the enhanced CT and was significantly superior to the routine color ultrasonography whose accuracy was only 63.6% (14/22).
Conclusion: Enhanced ultrasonography may provide more information on the characters, size, number and feeding vessels of the tumor before radiofrequency ablation, thus helping choose the indicator, establish and carry out the treatment protocol. This technique may also help to assess the therapeutic response to RFA.