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Usefulness of sonazoid–ultrasonography during hepatectomy in patients with liver tumors: A preliminary study

Authors

  • Atsushi Nanashima MD,

    Corresponding author
    1. Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
    • Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 8528501, Japan. Fax: 81-95-819-7306===

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  • Syuuichi Tobinaga MD,

    1. Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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  • Takafumi Abo MD,

    1. Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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  • Masaki Kunizaki MD,

    1. Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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  • Hiroaki Takeshita MD,

    1. Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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  • Shigekazu Hidaka MD,

    1. Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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  • Naota Taura MD,

    1. Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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  • Tatsuki Ichikawa MD,

    1. Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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  • Terumitsu Sawai MD,

    1. Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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  • Kazuhiko Nakao MD,

    1. Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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  • Takeshi Nagayasu MD

    1. Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Abstract

Background and Objectives

To improve diagnostic accuracy of intraoperative ultrasonography (IOUS), we investigated the usefulness of new contrast medium of microbubble agent, Sonazoid as a preliminary study.

Method

We examined IOUS in 50 patients with liver tumors who underwent hepatectomy. Sonazoid was administrated intravenously and Kupffer-phase images of the tumor were observed before hepatectomy. Sonazoid was reinjected to observe the tumor vasculature.

Results

The tumors included hepatocellular carcinoma (HCC) in 25 patients, intrahepatic cholangiocarcinoma in 3, colorectal liver metastasis in 14, gastrointestinal stromal tumor in 1, and benign hematoma in 1. Liver tumors were clearly detected as perfusion defect in most cases. Small lesions (<1 cm), extra-capsular tumor growth, and portal vein tumor thrombus were also clearly detected on the Sonazoid–IOUS. Small occult tumors were detected in five cases. Differential diagnosis with suspicious non-tumorous lesions and benign mass was possible based on vascular findings at the early phase. In comparison with hepatectomy for HCC under conventional IOUS, the proportion of patients with positive surgical margin (0%) tended to be lower than that of the control group (P = 0.073).

Conclusion

Sonazoid–IOUS is a promising useful tool to detect the precise tumor margin and small tumors, hence allowing curative hepatectomy or intraoperative ablation. J. Surg. Oncol. 2011; 103:152–157. © 2010 Wiley-Liss, Inc.

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