Fig. 2

Images of using SonoVue in radiofrequency ablation. Images of a 76-year-old man who had a 1.5-cm hepatocellular carcinoma (HCC) and hepatitis B virus-related liver cirrhosis and underwent CEUS-CT/MRI FI-guided radiofrequency ablation (RFA) with the use of SonoVue as a contrast agent. Arterial phase (A) and its subtraction MRI (B) demonstrates a small arterial-enhancing HCC (arrow) in liver segment 6. (C) In the hepatobiliary phase (20-min delayed phase), the tumor at segment 6 of the liver showed a clear defect (arrow). On B-mode US (D) and following fusion imaging (E), it was not possible to identify the HCC on B-mode US at the corresponding site with fused MRI (arrow). Therefore, the index tumor was assigned a conspicuity score of 1, since it was definitely unidentifiable on fusion imaging. (F) Arterial-phase imaging obtained post-SonoVue injection showed a small enhanced lesion (arrow) that could be clearly identified at the corresponding location on fused MRI. (G) Radiofrequency electrodes (arrowheads) were inserted into the index tumor (arrow) with CEUS-added fusion imaging guidance. (H) Portal-phase CT obtained immediately post-RFA demonstrates technical success and sufficient ablation margins (arrowheads). LTP was not identified at the site of ablation after 10 months of the procedure