Fig. 3

Images of using Sonazoid in radiofrequency ablation. Images of a 58-year-old man who had a 1.1-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 Sonazoid as a contrast agent. (A) Arterial-phase MRI demonstrates a small hypervascular HCC (arrow) at the border of liver segments 5 and 8. (B) In hepatobiliary-phase (20-min delayed phase) MRI, the tumor at segment 5/8 border of the liver showed an apparent defect (arrow). (C) Following fusion imaging, it was not possible to identify the HCC on B-mode US imaging at the corresponding site on fused MRI (arrow). Therefore, the index tumor was assigned a conspicuity score of 1, as it was unidentifiable on fusion imaging. (D) Arterial-phase imaging obtained post-Sonazoid injection demonstrated an identifiable small enhanced lesion (arrow) at the corresponding location on fused MRI. (E) Kupffer-phase imaging identified the HCC (arrow) at the corresponding location on fused MRI. Therefore, the index tumor was assigned a conspicuity score of 4 on CEUS-added fusion imaging. (F) Radiofrequency electrodes (arrowheads) were positioned in the index tumor (arrow) with CEUS-CT/MRI FI guidance. (G) LTP was not identified at the site of ablation on portal-phase CT obtained 17 months post-RFA (arrowheads)