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 May;23(5):627-34. doi: 10.1016/j.jvir.2011.12.026. Epub 2012 Mar 2.

Abstract

Purpose: To assess factors affecting tumor visibility on planning ultrasound (US) for percutaneous radiofrequency (RF) ablation to treat small hepatocellular carcinomas (HCCs) primarily detected on computed tomography (CT) or magnetic resonance (MR) imaging.

Materials and methods: Patients referred for planning US for percutaneous RF ablation between September 2008 and June 2009 were prospectively enrolled from nine institutions in Korea. The first small (≤ 3 cm) single HCC or new single HCC after treatment was included. The study enrolled 898 patients (684 men and 214 women, age range 32-86 years). HCCs that were invisible on planning US were compared with visible HCCs with respect to tumor size, distance between the tumor and the diaphragm, subcapsular location, etiology of liver disease, liver cirrhosis, macronodular cirrhosis on US, ascites, Child-Pugh class, serum alpha fetoprotein (AFP) level, body mass index (BMI), previous treatments for HCC, previous chemoembolization treatments for HCC, institutions, and experience of radiologists.

Results: Among 898 HCCs, 671 (74.7%) were visible on the planning US. In multivariate analysis, tumor size, distance between the tumor and the diaphragm, liver cirrhosis, and macronodular cirrhosis were statistically significant factors affecting US detection (each P < .05).

Conclusions: Smaller tumors, subphrenic location of the tumor, liver cirrhosis, and macronodular cirrhosis were independent predictors of invisible tumors on planning US.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • Carcinoma, Hepatocellular / diagnostic imaging*
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / surgery*
  • Catheter Ablation*
  • Chi-Square Distribution
  • Clinical Competence
  • Contrast Media
  • Female
  • Humans
  • Liver Cirrhosis / diagnostic imaging
  • Liver Cirrhosis / pathology
  • Liver Cirrhosis / surgery
  • Liver Neoplasms / diagnostic imaging*
  • Liver Neoplasms / pathology
  • Liver Neoplasms / surgery*
  • Logistic Models
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Multidetector Computed Tomography*
  • Multivariate Analysis
  • Predictive Value of Tests
  • Prospective Studies
  • Republic of Korea
  • Severity of Illness Index
  • Tumor Burden
  • Ultrasonography, Interventional*
  • alpha-Fetoproteins / analysis

Substances

  • AFP protein, human
  • Contrast Media
  • alpha-Fetoproteins