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Evaluation Using Contrast‐Enhanced Harmonic Gray Scale Sonography After Radio Frequency Ablation of Small Hepatocellular Carcinoma
Author(s) -
Morimoto Manabu,
Nozawa Akinori,
Numata Kazushi,
Shirato Kazuhito,
Sugimori Kazuya,
Kokawa Atsushi,
Tomita Naohiko,
Saitou Toshifumi,
Nakatani Yukio,
Imada Toshio,
Tanaka Katsuaki
Publication year - 2005
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/jum.2005.24.3.273
Subject(s) - medicine , pathology , biopsy , hepatocellular carcinoma , h&e stain , ablation , radiology , second harmonic imaging microscopy , ultrasound , nuclear medicine , staining , laser , physics , optics , second harmonic generation
Objective To evaluate the usefulness of contrast‐enhanced harmonic wideband gray scale sonographic images obtained after radio frequency–induced coagulation necrosis, we compared the morphologic and histopathologic characteristics of the ablated tumors with sonographic images of the tumors. Methods Forty‐eight patients with 72 hepatocellular carcinomas with a maximal diameter of 3 cm or less were treated percutaneously using radio frequency ablation. Six treated tumors in 4 patients were resected 1 month after ablation; the remaining 66 treated tumors were evaluated by a biopsy procedure performed with an 18‐gauge fine needle 1 month after ablation. The excised tumors and biopsy specimens were then examined by histopathologic methods, and the findings were compared with those obtained on contrast‐enhanced harmonic wideband gray scale sonography. Hematoxylin‐eosin–stained specimens were inconclusive as to whether cellular viability remained; therefore, cell viability was determined by a positive result after histochemical (lactate dehydrogenase and nicotinamide adenine dinucleotide phosphate‐diaphorase) staining. Results Contrast‐enhanced harmonic wideband gray scale sonography after radio frequency ablation showed residual tumor enhancement in 5 (6.9%) of the 72 tumors; the histopathologic results for these 5 tumors were also positive for tumor residue. The remaining 67 tumors (93.1%) did not show any residual tumor enhancement when examined by sonography; however, only 66 tumors did not reveal tumor residue when examined histopathologically. Contrast‐enhanced harmonic wideband sonographic imaging provided results that were comparable with histopathologic findings, the criterion standard for diagnosis; the sensitivity and specificity of the sonographic images for the detection of residual tumor tissue in ablated tumors were 83.3% (5 of 6) and 100% (66 of 66), respectively. Conclusions Contrast‐enhanced harmonic wideband gray scale sonography is a potentially useful technique for evaluating the therapeutic effects of radio frequency ablation on hepatocellular carcinoma.