Premium
Contrast‐enhanced intraoperative ultrasound for hepatocellular carcinoma: high sensitivity of diagnosis and therapeutic impact
Author(s) -
Mitsunori Yusuke,
Tanaka Shinji,
Nakamura Noriaki,
Ban Daisuke,
Irie Takumi,
Noguchi Norio,
Kudo Atsushi,
Iijima Hiroko,
Arii Shigeki
Publication year - 2013
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1007/s00534-012-0507-9
Subject(s) - medicine , hepatocellular carcinoma , radiology , ultrasound , hepatectomy , contrast enhanced ultrasound , carcinoma , hccs , angiography , resection , surgery
Background Postoperative early recurrence is a crucial issue in the treatment of hepatocellular carcinoma (HCC) patients. Some early recurrences seem to occur from minute tumors which were overlooked during both preoperative and intraoperative investigations. Therefore, it is urgently necessary to increase detectability of minute HCCs during operation. If they could be detected and resected during surgery, the prognosis should be improved. The purpose of this study is to investigate the usefulness of contrast‐enhanced intraoperative ultrasound (CEIOUS) for the diagnosis and treatment of HCC. Methods Institutional ethics committee approval and informed consent were obtained. Fifty‐two patients (mean age 65 years; 38 males and 14 females) who underwent liver resection with either preoperative computed tomography during angiography (CTA) or CEIOUS with Sonazoid (perflubutane microbubble contrast agent) were studied. We determined the presence of HCC on the basis of the histopathological findings of resected specimens. Results The sensitivity of CEIOUS [97.6% (95% CI 91.8—99.4)] was higher than that of CTA [89.4% (95% CI 81.1—94.3)]. The positive predictive values of CEIOUS [91.2% (95% CI 83.6—95.5) and CTA [91.6% (95% CI 83.6—95.9)] were similar. Eight new HCCs from 7 patients, which accounted for 9.4% (8/85) of the total HCCs, were correctly detected and diagnosed by CEIOUS, and we performed an additional partial hepatectomy in 3 of these 7 patients. Conclusions CEIOUS with Sonazoid provided increased sensitivity of detection of small HCCs compared with preoperative CTA, thereby leading to a more appropriate surgical procedure and contributing to complete tumor removal.