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The Use of Contrast-Enhanced Ultrasonography in the Selection of Patients With Hepatocellular Carcinoma for Radio Frequency Ablation Therapy

Department of Ultrasound, School of Oncology, Peking University, Beijing, China.

Address correspondence to Min-Hua Chen, MD, Department of Ultrasound, School of Oncology, Peking University, Beijing Cancer Hospital and Institute, 52 Fu-Cheng Rd, Haidian District, 100036 Beijing, China. E-mail: minhuachen{at}bjcancer.org, minhuachen{at}vip.sina.com

Objective. The purpose of this study was to evaluate the use of contrast-enhanced ultrasonography (CEUS) in selecting patients with hepatocellular carcinoma (HCC) for radio frequency ablation (RFA). Methods. One hundred seventy-nine patients with HCC were divided into 2 groups before receiving RFA: a CEUS group and a control group. The patients were concatenated and alternately apportioned into these 2 groups. In the CEUS group, 92 patients underwent pre-RFA CEUS using the contrast agent sulfur hexafluoride and enhanced computed tomography or magnetic resonance imaging before RFA for selecting suitable cases for RFA, and in the control group, conventional ultrasonography and enhanced computed tomography or magnetic resonance imaging were performed in 87 patients for selecting patients. Results. In the CEUS group, 9 patients (9.8%) were excluded for RFA therapy by CEUS. The other 83 patients (90.2%), with a total of 114 lesions, were treated by RFA. In the control group, 5 patients (5.7%) were excluded for RFA. The other 82 patients (94.3%), with a total of 107 lesions, were treated by RFA. During the follow-up period of 18 to 50 months, the primary technique effectiveness rates in the CEUS and control groups were 94.7% and 87.9%, respectively (P = .1182). The local tumor progression rate, the new HCC rate, and the repeated RFA rate of the CEUS group were significantly lower than those of the control group (P = .033, .004, and .001, respectively). Conclusions. Pre-RFA CEUS provides important information for selecting suitable patients for RFA. The use of CEUS in selecting patients with HCC can decrease post-RFA local tumor progression and improve the efficacy of RFA therapy.

Key Words: contrast-enhanced ultrasonography • hepatocellular carcinoma • indications • radio frequency ablation therapy

Abbreviations: CEUS, contrast-enhanced ultrasonography • CT, computed tomography • HCC, hepatocellular carcinoma • MRI, magnetic resonance imaging • RFA, radio frequency ablation