Nonresectable Hepatocellular Carcinoma

OBJECTIVE. The purpose of our study was to evaluate the usefulness of percutaneous ethanol installation using CO2-enhanced sonography for patients with nonresectable hepatocellular carcinoma (HCC).SUBJECTS AND METHODS. Forty-six patients with 65 HCC lesions were examined with contrast-enhanced sonography with direct injection of CO2 into the proper hepatic artery during arteriography. We performed percutaneous ethanol injection guided by CO2-enhanced sonography for the treatment of hypervascular HCC lesions that could not be treated with conventional percutaneous ethanol injection or with transcatheter arterial embolization.RESULTS. CO2-enhanced sonography detected five additional small HCC lesions before treatment (p<0.05) and 14 new lesions during follow-up (p<0.01), than conventional sonography detected. CO2-enhanced sonography showed positive enhancement of residual lesions after initial treatment (n = 3) and incomplete local treatment (n = 5) that were not detected on conventional sonography. These 2...