Contrast-Enhanced Sonography With Abdominal Virtual Sonography in Monitoring Radiofrequency Ablation of Hepatocellular Carcinoma

Background. Contrast-enhanced CT is regarded as the gold standard for monitoring radio-frequency ablation (RFA) of hepatocellular carcinoma (HCC). Recently, 3-dimensional volume data from CT have been used to create cross-sectional multiplanar reconstruction images. Using this technique, we can reconstruct 2-dimensional CT images identical in orientation to ultrasound (US) images, which we call virtual sonographic (VUS) images. The present prospective randomized control trial compared the number of CT scans needed to assess the efficacy of RFA of HCC using VUS-contrast-enhanced ultrasonography (CEUS) versus CT. Method. Subjects comprised 50 patients (50 HCCs) treated with US-guided RFA between May 2005 and August 2006, randomized to undergo assessment by CT (Group 1; 25 HCC nodules) or VUS-CEUS (Group 2; 25 HCC nodules). All patients were followed for 1 year. Primary endpoint was whether the number of CT scans could be reduced using VUS-CEUS. Result. Mean number of CT scans required was 1.64 +/- 0.7 in Group 1 and 1.1 +/- 0.2 in Group 2 (p < 0.001). Conclusion. VUS-CEUS can be used to assess the efficacy of HCC of RFA, with the potential to reduce the number of CT scans required for that purpose. (C) 2009 Wiley Periodicals, Inc. J Clin Ultrasound 38:138-144, 2010; Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/jcu.20654