Takamichi Murakami MD, PhD, Abstract Co-Author: Nothing to Disclose

Takatoshi Kitada MD,PhD, Abstract Co-Author: Nothing to Disclose

Keigo Osuga MD, Abstract Co-Author: Nothing to Disclose

Shinji Tamura, Abstract Co-Author: Nothing to Disclose

Hironobu Nakamura MD, PhD, Abstract Co-Author: Nothing to Disclose

Noboru Maeda, Presenter: Nothing to Disclose

Bunichiro Kishino MD,PhD, Abstract Co-Author: Nothing to Disclose

Kahori Minamidani, Abstract Co-Author: Nothing to Disclose

Kazuya Nakajyo, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

Real-time virtual sonography (RVS) can synchronize B-mode ultrasound (US) images with multiplanar reconstruction (MPR)-computed tomography (CT) images and display both images in the same slice section simultaneously. The purpose of this study is to assess the precision of RVS and therapeutic efficacy of radiofrequency ablation (RFA) therapy for hepatocellular carcinoma (HCC).

Eight patients with a solitary HCC ranged from 2cm to 3.5cm in diameter underwent RVS-guided RFA therapy using cooled-tip needle within a week after the transcatheter arterial embolization (TAE) with iodized oil and gelatin sponge particles.Immediately after RFA therapy without withdrawing the needle, CT images were obtained, and MPR CT image parallel to the needle was reconstructed from the volume data of CT images to evaluate the position of cooled-tip needle. The distance between cooled-tip needle and the center of tumor was measured as “error”. For all the 8 patients, more than 6 months follow up with enhanced CT imaging was performed to evaluate Local control ablity.

In all the 8 patients, we could syncronize b-mode US images with MPR CT images reconstructed from the portal venous phase images. The error of the distance between cooled-tip needle and the center of liver tumor ranged from 0 to 3.2 mm (mean 1.6mm). In all the 8 patients, contrast-enhanced CT images obtained 4 days after RFA demonstrated a nonenhanced area including the previously identified HCC, which was suggestive of complete necrosis of tumor. All 8 HCC nodules showed no local recurrence during a mean follow-up of 7 months. No patients had major complications during this period.

By using RVS-guided RFA, small HCC could be treated precisely and completely. It would be a useful tool for treatment of HCC.

Murakami, T, Kitada, T, Osuga, K, Tamura, S, Nakamura, H, Maeda, N, Kishino, B, Minamidani, K, Nakajyo, K, et al, , The Precision and Effectiveness of Real-time Virtual Sonography on Radiofrequency Ablation for Hepatocellular Carcinoma.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4406974.html