Contrast Harmonic Sonography-Guided Radiofrequency Ablation Therapy Versus B-Mode Sonography in Hepatocellular Carcinoma: Prospective Randomized Controlled Trial

The purpose of this study was to evaluate the effectiveness of contrast harmonic sonographic guidance in radiofrequency ablation of locally progressive hepatocellular carcinoma poorly depicted with B-mode sonography. A series of 40 patients with hepatocellular carcinoma with local tumor progression poorly depicted with B-mode sonography were randomly treated with radiofrequency ablation guided by either contrast harmonic sonography (n = 20) or conventional B-mode sonography (n = 20). Unpaired Student's t tests were performed to compare numbers of treatment sessions. Treatment analysis showed that the complete ablation rate after a single treatment session was significantly higher in the contrast harmonic sonography group than in the B-mode sonography group (94.7% vs 65.0%; p = 0.043) and that the number of treatment sessions was significantly lower in the contrast harmonic sonography group (mean, 1.1 +/- 0.2 vs 1.4 +/- 0.6; p =0.037). Contrast harmonic sonography-guided radiofrequency ablation is an efficient technique for guiding further ablation of local tumor progression not clearly demarcated with B-mode sonography.