[Application of contrast-enhanced ultrasonography in selecting indication of radiofrequency ablation among hepatocellular carcinoma patients].

OBJECTIVE

To evaluate the clinical value of contrast-enhanced ultrasound (CEUS) in selection of the patients with hepatocellular carcinoma (HCC) indicated to radiofrequency ablation (RFA).

METHODS

164 patients with HCC, 121 males and 43 females, aged 52.4 (38-72), who asked for RFA were randomly divided into 2 groups: 81 patients undergoing CEUS before RFA (CEUS Group), and 83 patients not undergoing CEUS before RFA (Control Group). There were not significant differences in the TNM staging, liver function Child-Pugh classing, and average tumor size between the 2 groups. Follow-up by conventional ultrasonography, enhanced CT and/or enhanced ultrasonography was conducted for 6-36 months.

RESULTS

Nine of the 81 patients in CEUS Group (11.8%) were determined by CEUS as unsuitable for RFA; 5 of the 9 patients had more than 5 lesions, 2 of the 9 patients had lesions > 8 cm in diameter, and the tumor had invaded 2 large vessels or intestine in 2 of the 9 patients. The other 72 patients in CEUS Group, with 101 lesions, underwent RFA after CEUS. CEUS discovered 12 lesions < or = 1.7 cm that had not been discovered by conventional ultrasonography and CT in 8 patients, 3 of which were patients with cirrhosis undergoing follow-up, and 2 of which were HCC patients undergoing follow-up after treatment. Of these 8 patients, 3 had 7 newly discovered satellite lesions around the main lesions. The successful rates of CEUS Group and Control Group were 95.0% and 89.6% respectively (P > 0.05). The distant recurrence rate of Control Group was 22.9%, significantly higher than that of CEUS Group (9.7%, P < 0.05).

CONCLUSION

Helping find minute tumors, CEUS is useful in selecting HCC patients suitable for RFA, thus decreasing the intrahepatic recurrence after RFA.