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Journal of Hepato-Biliary-Pancreatic Sciences

Published in:

01-02-2013 | Original article

Contrast-enhanced intraoperative ultrasound for hepatocellular carcinoma: high sensitivity of diagnosis and therapeutic impact

Authors: Yusuke Mitsunori, Shinji Tanaka, Noriaki Nakamura, Daisuke Ban, Takumi Irie, Norio Noguchi, Atsushi Kudo, Hiroko Iijima, Shigeki Arii

Published in: Journal of Hepato-Biliary-Pancreatic Sciences | Issue 2/2013

Abstract

Background

Postoperative early recurrence is a crucial issue in the treatment of hepatocellular carcinoma (HCC) patients. Some early recurrences seem to occur from minute tumors which were overlooked during both preoperative and intraoperative investigations. Therefore, it is urgently necessary to increase detectability of minute HCCs during operation. If they could be detected and resected during surgery, the prognosis should be improved. The purpose of this study is to investigate the usefulness of contrast-enhanced intraoperative ultrasound (CEIOUS) for the diagnosis and treatment of HCC.

Methods

Institutional ethics committee approval and informed consent were obtained. Fifty-two patients (mean age 65 years; 38 males and 14 females) who underwent liver resection with either preoperative computed tomography during angiography (CTA) or CEIOUS with Sonazoid (perflubutane microbubble contrast agent) were studied. We determined the presence of HCC on the basis of the histopathological findings of resected specimens.

Results

The sensitivity of CEIOUS [97.6% (95% CI 91.8–99.4)] was higher than that of CTA [89.4% (95% CI 81.1–94.3)]. The positive predictive values of CEIOUS [91.2% (95% CI 83.6–95.5) and CTA [91.6% (95% CI 83.6–95.9)] were similar. Eight new HCCs from 7 patients, which accounted for 9.4% (8/85) of the total HCCs, were correctly detected and diagnosed by CEIOUS, and we performed an additional partial hepatectomy in 3 of these 7 patients.

Conclusions

CEIOUS with Sonazoid provided increased sensitivity of detection of small HCCs compared with preoperative CTA, thereby leading to a more appropriate surgical procedure and contributing to complete tumor removal.

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Title: Contrast-enhanced intraoperative ultrasound for hepatocellular carcinoma: high sensitivity of diagnosis and therapeutic impact
Authors: Yusuke Mitsunori
Shinji Tanaka
Noriaki Nakamura
Daisuke Ban
Takumi Irie
Norio Noguchi
Atsushi Kudo
Hiroko Iijima
Shigeki Arii
Publication date: 01-02-2013
Publisher: Springer Japan
Published in: Journal of Hepato-Biliary-Pancreatic Sciences / Issue 2/2013
Print ISSN: 1868-6974
Electronic ISSN: 1868-6982
DOI: https://doi.org/10.1007/s00534-012-0507-9

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Springer Medicine

Contrast-enhanced intraoperative ultrasound for hepatocellular carcinoma: high sensitivity of diagnosis and therapeutic impact

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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