Utility of contrast‐enhanced ultrasonography with Sonazoid in radiofrequency ablation for hepatocellular carcinoma

Masuzaki, Ryota; Shiina, Shuichiro; Tateishi, Ryosuke; Yoshida, Haruhiko; Goto, Eriko; Sugioka, Yosuke; Kondo, Yuji; Goto, Tadashi; Ikeda, Hitoshi; Omata, Masao; Koike, Kazuhiko

doi:10.1111/j.1440-1746.2010.06559.x

Cited by 85 publications

(76 citation statements)

References 22 publications

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“…In such cases, observation with Sonazoid™ CEUS may be effective. In addition, compared with the historical controls that were in place prior to the availability of Sonazoid™, the number of RFA sessions per treatment is reported to have decreased (25). Therefore, the effectiveness of Sonazoid™ CEUS in RFA has been confirmed.…”

Section: Discussionmentioning

confidence: 80%

Effect of treatment support on preventing local recurrence of hepatocellular carcinoma directly adjacent to the diaphragm

Ishikawa

Imai

et al. 2017

Molecular and Clinical Oncology

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Abstract. Treatment support is anticipated to improve the results of radiofrequency ablation (RFA) treatment in cases in which visualization of tumors using the conventional B-mode is unclear. In the present study, the effectiveness of treatment support for RFA reducing the local recurrence rate of hepatocellular carcinoma (HCC) that are located directly adjacent to the diaphragm, and which are difficult to visualize with B-mode ultrasound imaging, was investigated. A total of 103 HCC tumors measuring <5 cm, which were located abutting the diaphragm, and which were difficult to visualize using the B-mode, were treated using RFA. Thirty-three of those HCC tumors were treated using RFA without treatment support, whereas the remaining 70 HCC tumors were treated using RFA with treatment support, including artificial pleural effusion, contrast-enhanced ultrasonography (CEUS) with the contrasting agent, Sonazoid™, and fusion imaging, either alone or in combination to improve the visualization of the tumors. The rate of local recurrence, and factors affecting local recurrence, were analyzed. Local recurrences were confirmed in 17 of the 103 nodules (16.50%). The overall rate of local recurrence was 13.1% at 6 months, and 20.2% at 12 months. The rate of local recurrence using RFA with artificial pleural effusion was significantly lower compared with those cases of HCC tumors treated without artificial pleural effusion (P=0.008). Similarly, the rate of local recurrence for CEUS RFA with Sonazoid™ was significantly lower compared with those cases of HCC tumors treated without Sonazoid™ (P=0.00081). In a multivariate analysis, CEUS RFA with Sonazoid™ and artificial pleural effusion contributed to the decrease in the rate of local recurrence (hazard ratios, 0.075 and 0.143, respectively). Based on these results, it is possible to conclude that CEUS with Sonazoid™ as a treatment support was the most effective method for reducing the rate of local recurrences abutting the diaphragm that are difficult to visualize using B-mode ultrasonography. IntroductionHepatocellular carcinoma (HCC) is the fifth most common cancer in men, and the seventh most common cancer in women worldwide, and it is the most common cause of cancer-associated mortality (1). Radiofrequency ablation (RFA) was first described by Rossi et al (2) as a local thermal ablation therapy for HCC. It has been endorsed as a curative treatment modality by several clinical management guidelines for early-stage, unresectable HCC (3-9). However, to further improve the treatment outcomes of RFA for HCC, it is important to accurately identify the position of tumors on performing ultrasonography. Even in cases for which the visualization of tumors is difficult with the conventional B-mode ultrasound imaging, performing RFA using treatment support such as artificial pleural effusion, fusion imaging, and contrast-enhanced ultrasound with Sonazoid™ (Perflubutane; Daiichi Sankyo Co., Ltd., Tokyo, Japan), is expected to improve treatment outcomes in clinical settings (10).The aim...

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Section: Discussionmentioning

confidence: 80%

Effect of treatment support on preventing local recurrence of hepatocellular carcinoma directly adjacent to the diaphragm

Ishikawa

Imai

et al. 2017

Molecular and Clinical Oncology

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“…2,12 Along with fusion imaging, contrast-enhanced sonography is widely used for interventional procedures on focal hepatic lesions. [13][14][15] However, compared with the fusion imaging technique, contrast-enhanced sonography is very much an operator-dependent technique and requires additional cost. Moreover, contrast-enhanced sonography can be challenging in localizing multiple or deeply located tar- get lesions because the temporal window of the arterial phase is not long enough, and detecting signals occurring due to microbubbles is limited in deeply located lesions.…”

Section: Discussionmentioning

confidence: 99%

Fusion Imaging–Guided Percutaneous Biopsy of Focal Hepatic Lesions With Poor Conspicuity on Conventional Sonography

Park

Lee

et al. 2013

J of Ultrasound Medicine

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iver biopsy and radiofrequency ablation of focal hepatic lesions is widely performed under sonographic guidance, mainly because sonography is convenient, safe, and easily accessible, and it offers real-time guidance for interventional procedures. However, we quite frequently encounter focal hepatic lesions that have poor sonographic conspicuity; thus, it is difficult to accurately localize and target the index lesion. When the biopsy specimen is not adequate for pathologic examination, another biopsy is Hyun Jeong Park, MD, Min Woo Lee, MD, Mi Hee Lee, MD, Jiyoung Hwang, MD, Tae Wook Kang, MD, Sanghyeok Lim, MD, Hyunchul Rhim, MD, Hyo K. Lim, MD Received October 12, 2012, ORIGINAL RESEARCHObjectives-The purpose of this study was to evaluate the effectiveness of real-time fusion imaging (sonography combined with computed tomography or magnetic resonance imaging) for percutaneous sonographically guided biopsy of focal hepatic lesions with poor sonographic conspicuity.Methods-This study was conducted as a retrospective analysis of a prospective database and was approved by the Institutional Review Board. Patients who had target lesions with poor conspicuity on B-mode sonography for percutaneous biopsy were enrolled in the study. Lesion conspicuity was assessed by conventional B-mode sonography first and then by fusion imaging later in the same session. We compared lesion conspicuity and detection rates between B-mode sonography and fusion imaging and evaluated how many cases of initially invisible lesions on B-mode sonography became visible on fusion imaging. The technical success rate was evaluated on the basis of the final diagnoses, which were established by pathologic examination of the biopsy specimens as well as follow-up clinical and radiologic examinations.Results-A total of 22 patients were enrolled in the study. On fusion imaging, lesion conspicuity was increased in 63.6% of focal hepatic lesions (14 of 22). Moreover, 66.7% of lesions (6 of 9) that were invisible on B-mode sonography became visible on fusion imaging. The true-positive detection rate was significantly different between B-mode sonography and fusion imaging (9 of 22 versus 19 of 22; P = .0044). Percutaneous biopsy was performed for all lesions, including 3 target lesions that were invisible even on fusion imaging. The technical success rate was 95.5% (21 of 22).Conclusions-Fusion imaging is effective for percutaneous biopsy of focal hepatic lesions with poor sonographic conspicuity.

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“…As second-generation contrast agents including SonoVue and Sonazoid have been developed, CEUS has emerged as a rescue method for RFA for inconspicuous small HCC on B-mode US. Several studies reported that CEUS using Sonazoid was very useful in RFA for small HCCs (15,25). In one study, the initial success rate was 94%, and there was no case with local tumor progression during follow-up (15).…”

Section: Discussionmentioning

confidence: 99%

“…There are some new techniques to overcome the limitation of B-mode US-guided RFA (22)(23)(24)(25)(26)(27)(28)(29). One of the new techniques is fusion imaging-guided RFA.…”

Section: Discussionmentioning

confidence: 99%

Contrast-enhanced ultrasound-guided radiofrequency ablation in inconspicuous hepatocellular carcinoma on B-mode ultrasound

Kim¹,

Kim²,

Shin³

et al. 2017

Turk J Gastroenterol

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Recently, novel contrast agents for ultrasound have been developed to improve the diagnostic yield. SonoVue (Bracco, Milan, Italy) and Sonazoid (Daiichi-SanTurk J Gastroenterol 2017; 28: 446-52 Contrast-enhanced ultrasound-guided radiofrequency ablation in inconspicuous hepatocellular carcinoma on B-mode ultrasound Eui Joo Kim , Yun Soo Kim , Seung Kak Shin , Oh Sang Kwon , Duck Joo Choi , Ju LiverOriginal Article

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Utility of contrast‐enhanced ultrasonography with Sonazoid in radiofrequency ablation for hepatocellular carcinoma

Abstract: CEUS with Sonazoid is useful for HCC detection in patients with a well-conserved liver function reservoir. The decrease in RFA session numbers indicated the utility of Sonazoid in RFA treatment of HCC.

Cited by 85 publications

References 22 publications

Effect of treatment support on preventing local recurrence of hepatocellular carcinoma directly adjacent to the diaphragm

Effect of treatment support on preventing local recurrence of hepatocellular carcinoma directly adjacent to the diaphragm

Fusion Imaging–Guided Percutaneous Biopsy of Focal Hepatic Lesions With Poor Conspicuity on Conventional Sonography

Contrast-enhanced ultrasound-guided radiofrequency ablation in inconspicuous hepatocellular carcinoma on B-mode ultrasound

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