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Purpose: To assess factors affecting tumor visibility on planning ultrasound (US) for percutaneous radiofrequency (RF) ablation to treat small hepatocellular carcinomas (HCCs) primarily detected on computed tomography (CT) or magnetic resonance (MR) imaging. Materials and Methods: Patients referred for planning US for percutaneous RF ablation between September 2008 and June 2009 were prospectively enrolled from nine institutions in Korea. The first small (≤ 3 cm) single HCC or new single HCC after treatment was included. The study enrolled 898 patients (684 men and 214 women, age range 32-86 years). HCCs that were invisible on planning US were compared with visible HCCs with respect to tumor size, distance between the tumor and the diaphragm, subcapsular location, etiology of liver disease, liver cirrhosis, macronodular cirrhosis on US, ascites, Child-Pugh class, serum alpha fetoprotein (AFP) level, body mass index (BMI), previous treatments for HCC, previous chemoembolization treatments for HCC, institutions, and experience of radiologists. Results: Among 898 HCCs, 671 (74.7%) were visible on the planning US. In multivariate analysis, tumor size, distance between the tumor and the diaphragm, liver cirrhosis, and macronodular cirrhosis were statistically significant factors affecting US detection (each P < .05). Conclusions: Smaller tumors, subphrenic location of the tumor, liver cirrhosis, and macronodular cirrhosis were independent predictors of invisible tumors on planning US. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: To assess factors affecting tumor visibility on planning ultrasound (US) for percutaneous radiofrequency (RF) ablation to treat small hepatocellular carcinomas (HCCs) primarily detected on computed tomography (CT) or magnetic resonance (MR) imaging. Materials and Methods: Patients referred for planning US for percutaneous RF ablation between September 2008 and June 2009 were prospectively enrolled from nine institutions in Korea. The first small (≤ 3 cm) single HCC or new single HCC after treatment was included. The study enrolled 898 patients (684 men and 214 women, age range 32–86 years). HCCs that were invisible on planning US were compared with visible HCCs with respect to tumor size, distance between the tumor and the diaphragm, subcapsular location, etiology of liver disease, liver cirrhosis, macronodular cirrhosis on US, ascites, Child-Pugh class, serum alpha fetoprotein (AFP) level, body mass index (BMI), previous treatments for HCC, previous chemoembolization treatments for HCC, institutions, and experience of radiologists. Results: Among 898 HCCs, 671 (74.7%) were visible on the planning US. In multivariate analysis, tumor size, distance between the tumor and the diaphragm, liver cirrhosis, and macronodular cirrhosis were statistically significant factors affecting US detection (each P < .05). Conclusions: Smaller tumors, subphrenic location of the tumor, liver cirrhosis, and macronodular cirrhosis were independent predictors of invisible tumors on planning US. [Copyright &y& Elsevier]

Purpose: To evaluate the features of the Günther-Tulip filter (GTF) with or without tilting toward the anterior or posterior direction with use of phantom models and to describe our preliminary clinical experience to detect tilting and to reposition the GTF with regard to the maneuver's feasibility and usefulness. Materials and Methods: Two types of phantom models were made by inserting a GTF in a tube with or without tilting toward the anterior or posterior direction. Changes of the fluoroscopic features were observed in the postero-anterior projection. For the clinical trials, transjugular placement of the GTF in the inferior vena cava (IVC) was performed in 12 patients. As the result of the phantom study, repositioning of the filter was repeated until the four anchoring hooks stood on an imaginary line before releasing. Finally, cavograms were obtained and the angles were measured between the axis of the filter and the IVC axis and the coronal plane in the lateral projection. Results: In the phantom study, the four anchoring hooks stood in a transverse imaginary line when the filter without tilting was located at the center of the fluoroscopic projection. In the clinical trials, the mean number of repositionings was 1.67, and the mean angles between the axis of the filter and the IVC axis and the coronal plane in the lateral projection of the cavogram were 0.08 degrees +/- 2.32 and 0.18 degrees +/- 5.09, respectively. Conclusions: For placement of the Günther-Tulip filter, the maneuver to detect tilting and to reposition it was feasible and useful to prevent tilting seen after initial placement. [ABSTRACT FROM AUTHOR]