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Role of contrast-enhanced ultrasonography with Sonazoid for hepatocellular carcinoma: evidence from a 10-year experience

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Abstract

Hepatocellular carcinoma (HCC) represents primary liver cancer. Because the development of HCC limits the prognosis as well as the quality of life of the patients, its management should be properly conducted based on an accurate diagnosis. The liver is the major target organ of ultrasound (US), which is the simple, non-invasive, and real-time imaging method available worldwide. Microbubble-based contrast agents are safe and reliable and have become popular, which has resulted in the improvement of diagnostic performances of US due to the increased detectability of the peripheral blood flow. Sonazoid (GE Healthcare, Waukesha, WI, USA), a second-generation contrast agent, shows the unique property of accumulation in the liver and spleen. Contrast-enhanced US with Sonazoid is now one of the most frequently used modalities in the practical management of liver tumors, including the detection and characterization of the nodule, evaluation of the effects of non-surgical treatment, intraoperative support, and post-treatment surveillance. This article reviews the 10-year evidence for contrast-enhanced US with Sonazoid in the practical management of HCC.

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Abbreviations

AUROC:

Area under the receiver operating characteristic curve

CEUS:

Contrast-enhanced ultrasound

CT:

Computed tomography

CTA:

CT arteriography

CTAP:

CT arterioportal angiography

DN:

Dysplastic nodule

EOB-MRI:

Gadolinium-ethoxybenzyl diethylenetriaminepentaacetic acid-MRI

HCC:

Hepatocellular carcinoma

ICC:

Intrahepatic cholangiocellular carcinoma

mHCC:

Moderately differentiated hepatocellular carcinoma

MIP:

Maximum intensity projection

NFLL:

New focal liver lesions

NS:

Not statistically significant

PR:

Partial response

PD:

Progressive disease

pHCC:

Poorly differentiated hepatocellular carcinoma

RN:

Regenerative nodule

RFA:

Radiofrequency ablation

SD:

Stable disease

S-CEUS:

Contrast-enhanced ultrasound with Sonazoid

SPIO-MRI:

Superparamagnetic iron oxide magnetic resonance imaging

TACE:

Transcatheter arterial chemoembolization

US:

Ultrasound

wHCC:

Well-differentiated hepatocellular carcinoma

References

  1. Kudo M, Matsui O, Izumi N, Liver Cancer Study Group of Japan, et al. Surveillance and diagnostic algorithm for hepatocellular carcinoma proposed by the Liver Cancer Study Group of Japan: 2014 update. Oncology. 2014;87(Suppl 1):7–21.

    Article  PubMed  Google Scholar 

  2. Jang HJ, Kim TK, Burns PN, et al. CEUS: an essential component in a multimodality approach to small nodules in patients at high-risk for hepatocellular carcinoma. Eur J Radiol. 2015;84:1623–35.

    Article  PubMed  Google Scholar 

  3. Bouakaz A, de Jong N. WFUMB Safety Symposium on Echo-Contrast Agents: nature and types of ultrasound contrast agents. Ultrasound Med Biol. 2007;33:187–96.

    Article  PubMed  Google Scholar 

  4. Numata K, Luo W, Morimoto M, et al. Contrast-enhanced ultrasound of hepatocellular carcinoma. World J Radiol. 2010;2:68–82.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Claudon M, Dietrich CF, Choi BI, et al. Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS) in the liver—update 2012: a WFUMB-EFSUMB initiative in cooperation with representatives of AFSUMB, AIUM, ASUM, FLAUS and ICUS. Ultrasound Med Biol. 2013;39:187–210.

    Article  PubMed  Google Scholar 

  6. Sontum PC. Physicochemical characteristics of SonazoidTM, a new contrast agent for ultrasound imaging. Ultrasound Med Biol. 2008;34:824–33.

    Article  PubMed  Google Scholar 

  7. Sasaki S, Iijima H, Moriyasu F, Hidehiko W. Definition of contrast enhancement phases of the liver using a perfluoro-based microbubble agent, perflubutane microbubbles. Ultrasound Med Biol. 2009;35:1819–27.

    Article  Google Scholar 

  8. Drugs in Japan forum. Drugs in Japan, ethical drugs 2011. Tokyo: Jiho; 2010.

    Google Scholar 

  9. Moriyasu F, Itoh K. Efficacy of perflubutane microbubble-enhanced ultrasound in the characterization and detection of focal liver lesions: phase 3 multicenter clinical trial. AJR Am J Roentgenol. 2009;193:86–95.

    Article  PubMed  Google Scholar 

  10. Shimada T, Maruyama H, Sekimoto T, et al. Heterogeneous staining in the liver parenchyma after the injection of perflubutane microbubble contrast agent. Ultrasound Med Biol. 2012;38:1317–23.

    Article  PubMed  Google Scholar 

  11. Inoue T, Kudo M, Hatanaka K, et al. Imaging of hepatocellular carcinoma: qualitative and quantitative analysis of post vascular phase contrast-enhanced ultrasonography with Sonazoid. Comparison with super paramagnetic iron oxide magnetic resonance images. Oncology. 2008;75(Suppl 1):48–54.

    Article  PubMed  Google Scholar 

  12. Goto E, Masuzaki R, Tateishi R, et al. Value of post-vascular phase (Kupffer imaging) by contrast-enhanced ultrasonography using Sonazoid in the detection of hepatocellular carcinoma. J Gastroenterol. 2012;47:477–85.

    Article  PubMed  Google Scholar 

  13. Hatanaka K, Chung H, Kudo M, et al. Usefulness of the post-vascular phase of contrast-enhanced ultrasonography with Sonazoid in the evaluation of gross types of hepatocellular carcinoma. Oncology. 2010;78(Suppl 1):53–9.

    Article  PubMed  Google Scholar 

  14. Tada T, Kumada T, Toyoda H, et al. Utility of contrast-enhanced ultrasound with perflubutane for diagnosing the macroscopic type of small nodular hepatocellular carcinomas. Eur Radiol. 2014;24:2157–66.

    Article  PubMed  Google Scholar 

  15. Hatanaka K, Minami Y, Kudo M, et al. The gross classification of hepatocellular carcinoma: usefulness of contrast-enhanced US. J Clin Ultrasound. 2014;42:1–8.

    Article  PubMed  Google Scholar 

  16. Mandai M, Koda M, Matono T, et al. Assessment of hepatocellular carcinoma by contrast-enhanced ultrasound with perfluorobutane microbubbles: comparison with dynamic CT. Br J Radiol. 2011;84:499–507.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Numata K, Fukuda H, Miwa H, et al. Contrast-enhanced ultrasonography findings using a perflubutane-based contrast agent in patients with early hepatocellular carcinoma. Eur J Radiol. 2014;83:95–102.

    Article  PubMed  Google Scholar 

  18. Maruyama H, Takahashi M, Ishibashi H, et al. Contrast-enhanced ultrasound for characterisation of hepatic lesions appearing non-hypervascular on CT in chronic liver diseases. Br J Radiol. 2012;85:351–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Kudo M, Hatanaka K, Inoue T, et al. Depiction of portal supply in early hepatocellular carcinoma and dysplastic nodule: value of pure arterial ultrasound imaging in hepatocellular carcinoma. Oncology. 2010;78(Suppl 1):60–7.

    Article  PubMed  Google Scholar 

  20. Kita R, Sakamoto A, Nagata Y, et al. Visualization of blood drainage area from hypervascular hepatocellular carcinoma on ultrasonographic images during hepatic arteriogram: comparison with depiction of drainage area on contrast-enhanced ultrasound. Hepatol Res. 2012;42:999–1007.

    Article  PubMed  Google Scholar 

  21. Sugimoto K, Shiraishi J, Moriyasu F, et al. Computer-aided diagnosis of focal liver lesions by use of physicians’ subjective classification of echogenic patterns in baseline and contrast-enhanced ultrasonography. Acad Radiol. 2009;16:401–11.

    Article  PubMed  Google Scholar 

  22. Numata K, Fukuda H, Nihonmatsu H, et al. Use of vessel patterns on contrast-enhanced ultrasonography using a perflubutane-based contrast agent for the differential diagnosis of regenerative nodules from early hepatocellular carcinoma or high-grade dysplastic nodules in patients with chronic liver disease. Abdom Imaging. 2015;40:2372–83.

    Article  PubMed  Google Scholar 

  23. Luo W, Numata K, Kondo M, et al. Sonazoid-enhanced ultrasonography for evaluation of the enhancement patterns of focal liver tumors in the late phase by intermittent imaging with a high mechanical index. J Ultrasound Med. 2009;28:439–48.

    PubMed  Google Scholar 

  24. Hatanaka K, Kudo M, Minami Y, et al. Sonazoid-enhanced ultrasonography for diagnosis of hepatic malignancies: comparison with contrast-enhanced CT. Oncology. 2008;75(Suppl 1):42–7.

    Article  PubMed  Google Scholar 

  25. Kan M, Hiraoka A, Uehara T, et al. Evaluation of contrast-enhanced ultrasonography using perfluorobutane (Sonazoid®) in patients with small hepatocellular carcinoma: comparison with dynamic computed tomography. Oncol Lett. 2010;1:485–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  26. Takahashi M, Maruyama H, Shimada T, et al. Characterization of hepatic lesions (≤30 mm) with liver-specific contrast agents: a comparison between ultrasound and magnetic resonance imaging. Eur J Radiol. 2013;82:75–84.

    Article  PubMed  Google Scholar 

  27. Mita K, Kim SR, Kudo M, et al. Diagnostic sensitivity of imaging modalities for hepatocellular carcinoma smaller than 2 cm. World J Gastroenterol. 2010;16:4187–92.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Kawada N, Ohkawa K, Tanaka S, et al. Improved diagnosis of well-differentiated hepatocellular carcinoma with gadolinium ethoxybenzyl diethylene triamine pentaacetic acid-enhanced magnetic resonance imaging and Sonazoid contrast-enhanced ultrasonography. Hepatol Res. 2010;40:930–6.

    Article  PubMed  Google Scholar 

  29. Alaboudy A, Inoue T, Hatanaka K, et al. Usefulness of combination of imaging modalities in the diagnosis of hepatocellular carcinoma using Sonazoid®-enhanced ultrasound, gadolinium diethylene-triamine-pentaacetic acid-enhanced magnetic resonance imaging, and contrast-enhanced computed tomography. Oncology. 2011;81(Suppl 1):66–72.

    Article  PubMed  Google Scholar 

  30. Ohama H, Imai Y, Nakashima O, et al. Images of Sonazoid-enhanced ultrasonography in multistep hepatocarcinogenesis: comparison with Gd-EOB-DTPA-enhanced MRI. J Gastroenterol. 2014;49:1081–93.

    Article  CAS  PubMed  Google Scholar 

  31. Kudo M. Multistep human hepatocarcinogenesis: correlation of imaging with pathology. J Gastroenterol. 2009;44(Suppl 19):112–8.

    Article  PubMed  Google Scholar 

  32. Suzuki K, Okuda Y, Ota M, et al. Diagnosis of hepatocellular carcinoma nodules in patients with chronic liver disease using contrast-enhanced sonography: usefulness of the combination of arterial- and Kupffer-phase enhancement patterns. J Ultrasound Med. 2015;34:423–33.

    Article  PubMed  Google Scholar 

  33. Tanaka H, Iijima H, Higashiura A, et al. New malignant grading system for hepatocellular carcinoma using the Sonazoid contrast agent for ultrasonography. J Gastroenterol. 2014;49:755–63.

    Article  CAS  PubMed  Google Scholar 

  34. Kondo T, Maruyama H, Kiyono S, et al. Intensity-based assessment of microbubble-enhanced ultrasonography: phase-related diagnostic ability for cellular differentiation of hepatocellular carcinoma. Ultrasound Med Biol. 2015;41:3079–87.

    Article  PubMed  Google Scholar 

  35. Maruyama H, Takahashi M, Ishibashi H, et al. Changes in tumor vascularity precede microbubble contrast accumulation deficit in the process of dedifferentiation of hepatocellular carcinoma. Eur J Radiol. 2010;75:e102–6.

    Article  PubMed  Google Scholar 

  36. Takahashi M, Maruyama H, Ishibashi H, et al. Contrast-enhanced ultrasound with perflubutane microbubble agent: evaluation of differentiation of hepatocellular carcinoma. AJR Am J Roentgenol. 2011;196:W123–31.

    Article  PubMed  Google Scholar 

  37. Sugimoto K, Moriyasu F, Saito K, et al. Comparison of Kupffer-phase Sonazoid-enhanced sonography and hepatobiliary-phase gadoxetic acid-enhanced magnetic resonance imaging of hepatocellular carcinoma and correlation with histologic grading. J Ultrasound Med. 2012;31:529–38.

    PubMed  Google Scholar 

  38. Kondo T, Maruyama H, Sekimoto T, et al. Natural history of postvascular-phase iso-enhanced lesions on the sonogram in chronic liver diseases. J Gastroenterol Hepatol. 2014;29:165–72.

    Article  CAS  PubMed  Google Scholar 

  39. Korenaga K, Korenaga M, Furukawa M, et al. Usefulness of Sonazoid contrast-enhanced ultrasonography for hepatocellular carcinoma: comparison with pathological diagnosis and super paramagnetic iron oxide magnetic resonance images. J Gastroenterol. 2009;44:733–41.

    Article  PubMed  Google Scholar 

  40. Maruyama H, Takahashi M, Sekimoto T, et al. Heterogeneity of microbubble accumulation: a novel approach to discriminate between well-differentiated hepatocellular carcinomas and regenerative nodules. Ultrasound Med Biol. 2012;38:383–8.

    Article  PubMed  Google Scholar 

  41. Choi BI, Lee JM, Kim TK, et al. Diagnosing borderline hepatic nodules in hepatocarcinogenesis: imaging performance. AJR Am J Roentgenol. 2015;205:10–21.

    Article  PubMed  Google Scholar 

  42. Kudo M, Hatanaka K, Kumada T, et al. Double-contrast ultrasound: a novel surveillance tool for hepatocellular carcinoma. Am J Gastroenterol. 2011;106:368–70.

    Article  PubMed  Google Scholar 

  43. Maruyama H, Takahashi M, Ishibashi H, et al. Ultrasound-guided treatments under low acoustic power contrast harmonic imaging for hepatocellular carcinomas undetected by B-mode ultrasonography. Liver Int. 2009;29:708–14.

    Article  PubMed  Google Scholar 

  44. Miyamoto N, Hiramatsu K, Tsuchiya K, et al. Contrast-enhanced sonography-guided radiofrequency ablation for the local recurrence of previously treated hepatocellular carcinoma undetected by B-mode sonography. J Clin Ultrasound. 2010;38:339–45.

    PubMed  Google Scholar 

  45. Numata K, Morimoto M, Ogura T, et al. Ablation therapy guided by contrast-enhanced sonography with Sonazoid for hepatocellular carcinoma lesions not detected by conventional sonography. J Ultrasound Med. 2008;27:395–406.

    PubMed  Google Scholar 

  46. Minami Y, Kudo M, Hatanaka K, et al. Radiofrequency ablation guided by contrast harmonic sonography using perfluorocarbon microbubbles (Sonazoid) for hepatic malignancies: an initial experience. Liver Int. 2010;30:759–64.

    Article  PubMed  Google Scholar 

  47. Kudo M. New sonographic techniques for the diagnosis and treatment of hepatocellular carcinoma. Hepatol Res. 2007;37(Suppl 2):S193–9.

    Article  PubMed  Google Scholar 

  48. Kudo M, Hatanaka K, Maekawa K. Newly developed novel ultrasound technique, defect reperfusion ultrasound imaging, using Sonazoid in the management of hepatocellular carcinoma. Oncology. 2010;78(Suppl 1):40–5.

    Article  PubMed  Google Scholar 

  49. Ikeda K, Osaki Y, Nakanishi H, et al. Recent progress in radiofrequency ablation therapy for hepatocellular carcinoma. Oncology. 2014;87(Suppl 1):73–7.

    Article  PubMed  Google Scholar 

  50. Meloni MF, Smolock A, Cantisani V, et al. Contrast enhanced ultrasound in the evaluation and percutaneous treatment of hepatic and renal tumors. Eur J Radiol. 2015;84:1666–74.

    Article  PubMed  Google Scholar 

  51. Hiraoka A, Ichiryu M, Tazuya N, et al. Clinical translation in the treatment of hepatocellular carcinoma following the introduction of contrast-enhanced ultrasonography with Sonazoid. Oncol Lett. 2010;1:57–61.

    PubMed  PubMed Central  Google Scholar 

  52. Masuzaki R, Shiina S, Tateishi R, et al. Utility of contrast-enhanced ultrasonography with Sonazoid in radiofrequency ablation for hepatocellular carcinoma. J Gastroenterol Hepatol. 2011;26:759–64.

    Article  PubMed  Google Scholar 

  53. Dohmen T, Kataoka E, Yamada I, et al. Efficacy of contrast-enhanced ultrasonography in radiofrequency ablation for hepatocellular carcinoma. Intern Med. 2012;51:1–7.

    Article  PubMed  Google Scholar 

  54. Kudo M. Diagnostic imaging of hepatocellular carcinoma: recent progress. Oncology. 2011;81(Suppl 1):73–85.

    Article  CAS  PubMed  Google Scholar 

  55. Inoue T, Kudo M, Hatanaka K, et al. Usefulness of contrast-enhanced ultrasonography to evaluate the post-treatment responses of radiofrequency ablation for hepatocellular carcinoma: comparison with dynamic CT. Oncology. 2013;84(Suppl 1):51–7.

    Article  PubMed  Google Scholar 

  56. Nishigaki Y, Hayashi H, Tomita E, et al. Usefulness of contrast-enhanced ultrasonography using Sonazoid for the assessment of therapeutic response to percutaneous radiofrequency ablation for hepatocellular carcinoma. Hepatol Res. 2015;45:432–40.

    Article  PubMed  Google Scholar 

  57. Inoue T, Minami Y, Chung H, et al. Radiofrequency ablation for hepatocellular carcinoma: assistant techniques for difficult cases. Oncology. 2010;78(Suppl 1):94–101.

    Article  PubMed  Google Scholar 

  58. Andreana L, Kudo M, Hatanaka K, et al. Contrast-enhanced ultrasound techniques for guiding and assessing response to locoregional treatments for hepatocellular carcinoma. Oncology. 2010;78(Suppl 1):68–77.

    Article  PubMed  Google Scholar 

  59. Takahashi M, Maruyama H, Shimada T, et al. Linear enhancement after radio-frequency ablation for hepatocellular carcinoma: Is it a sign of recurrence? Ultrasound Med Biol. 2012;38:1902–10.

    Article  PubMed  Google Scholar 

  60. Maruyama H, Takahashi M, Shimada T, et al. Pretreatment microbubble-induced enhancement in hepatocellular carcinoma predicts intrahepatic distant recurrence after radiofrequency ablation. AJR Am J Roentgenol. 2013;200:570–7.

    Article  PubMed  Google Scholar 

  61. Xia Y, Kudo M, Minami Y, et al. Response evaluation of transcatheter arterial chemoembolization in hepatocellular carcinomas: the usefulness of sonazoid-enhanced harmonic sonography. Oncology. 2008;75(Suppl 1):99–105.

    Article  PubMed  Google Scholar 

  62. Takizawa K, Numata K, Morimoto M, et al. Use of contrast-enhanced ultrasonography with a perflubutane-based contrast agent performed 1 day after transarterial chemoembolization for the early assessment of residual viable hepatocellular carcinoma. Eur J Radiol. 2013;82:1471–80.

    Article  PubMed  Google Scholar 

  63. Kudo M. The 2008 Okuda lecture: management of hepatocellular carcinoma: from surveillance to molecular targeted therapy. J Gastroenterol Hepatol. 2010;25:439–52.

    Article  CAS  PubMed  Google Scholar 

  64. Shiozawa K, Watanabe M, Kikuchi Y, et al. Evaluation of sorafenib for hepatocellular carcinoma by contrast-enhanced ultrasonography: a pilot study. World J Gastroenterol. 2012;18:5753–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  65. Sugimoto K, Moriyasu F, Saito K, et al. Hepatocellular carcinoma treated with sorafenib: early detection of treatment response and major adverse events by contrast-enhanced US. Liver Int. 2013;33:605–15.

    Article  CAS  PubMed  Google Scholar 

  66. Abo T, Nanashima A, Tobinaga S, et al. Usefulness of intraoperative diagnosis of hepatic tumors located at the liver surface and hepatic segmental visualization using indocyanine green-photodynamic eye imaging. Eur J Surg Oncol. 2015;41:257–64.

    Article  CAS  PubMed  Google Scholar 

  67. Uchiyama K, Ueno M, Ozawa S, et al. Combined intraoperative use of contrast-enhanced ultrasonography imaging using a Sonazoid and fluorescence navigation system with indocyanine green during anatomical hepatectomy. Langenbecks Arch Surg. 2011;396:1101–7.

    Article  PubMed  Google Scholar 

  68. Nanashima A, Tobinaga S, Abo T, et al. Usefulness of Sonazoid-ultrasonography during hepatectomy in patients with liver tumors: a preliminary study. J Surg Oncol. 2011;103:152–7.

    Article  PubMed  Google Scholar 

  69. Arita J, Takahashi M, Hata S, et al. Usefulness of contrast-enhanced intraoperative ultrasound using Sonazoid in patients with hepatocellular carcinoma. Ann Surg. 2011;254:992–9.

    Article  PubMed  Google Scholar 

  70. Mitsunori Y, Tanaka S, Nakamura N, et al. Contrast-enhanced intraoperative ultrasound for hepatocellular carcinoma: high sensitivity of diagnosis and therapeutic impact. J Hepatobiliary Pancreat Sci. 2013;20:234–42.

    Article  PubMed  Google Scholar 

  71. Arita J, Hasegawa K, Takahashi M, et al. Correlation between contrast-enhanced intraoperative ultrasound using Sonazoid and histologic grade of resected hepatocellular carcinoma. AJR Am J Roentgenol. 2011;196:1314–21.

    Article  PubMed  Google Scholar 

  72. Sato K, Tanaka S, Mitsunori Y, et al. Contrast-enhanced intraoperative ultrasonography for vascular imaging of hepatocellular carcinoma: clinical and biological significance. Hepatology. 2013;57:1436–47.

    Article  CAS  PubMed  Google Scholar 

  73. Luo W, Numata K, Morimoto M, et al. Three-dimensional contrast-enhanced sonography of vascular patterns of focal liver tumors: pilot study of visualization methods. AJR Am J Roentgenol. 2009;192:165–73.

    Article  PubMed  Google Scholar 

  74. Luo W, Numata K, Morimoto M, et al. Clinical utility of contrast-enhanced three-dimensional ultrasound imaging with Sonazoid: findings on hepatocellular carcinoma lesions. Eur J Radiol. 2009;72:425–31.

    Article  PubMed  Google Scholar 

  75. Numata K, Fukuda H, Ohto M, et al. Evaluation of the therapeutic efficacy of high-intensity focused ultrasound ablation of hepatocellular carcinoma by three-dimensional sonography with a perflubutane-based contrast agent. Eur J Radiol. 2010;75:e67–75.

    Article  PubMed  Google Scholar 

  76. Kunishi Y, Numata K, Morimoto M, et al. Efficacy of fusion imaging combining sonography and hepatobiliary phase MRI with Gd-EOB-DTPA to detect small hepatocellular carcinoma. AJR Am J Roentgenol. 2012;198:106–14.

    Article  PubMed  Google Scholar 

  77. Makino Y, Imai Y, Ohama H, et al. Ultrasonography fusion imaging system increases the chance of radiofrequency ablation for hepatocellular carcinoma with poor conspicuity on conventional ultrasonography. Oncology. 2013;84(Suppl 1):44–50.

    Article  PubMed  Google Scholar 

  78. Min JH, Lim HK, Lim S, et al. Radiofrequency ablation of very-early-stage hepatocellular carcinoma inconspicuous on fusion imaging with B-mode US: value of fusion imaging with contrast-enhanced US. Clin Mol Hepatol. 2014;20:61–70.

    Article  PubMed  PubMed Central  Google Scholar 

  79. Numata K, Fukuda H, Morimoto M, et al. Use of fusion imaging combining contrast-enhanced ultrasonography with a perflubutane-based contrast agent and contrast-enhanced computed tomography for the evaluation of percutaneous radiofrequency ablation of hypervascular hepatocellular carcinoma. Eur J Radiol. 2012;81:2746–53.

    Article  PubMed  Google Scholar 

  80. Shindoh J, Seyama Y, Umekita N. Three-dimensional staining of liver segments with an ultrasound contrast agent as an aid to anatomic liver resection. J Am Coll Surg. 2012;215:e5–10.

    Article  PubMed  Google Scholar 

  81. Bota S, Piscaglia F, Marinelli S, et al. Comparison of international guidelines for noninvasive diagnosis of hepatocellular carcinoma. Liver Cancer. 2012;1:190–200.

    Article  PubMed  PubMed Central  Google Scholar 

  82. Tanaka H, Iijima H, Nouso K, et al. Cost-effectiveness analysis on the surveillance for hepatocellular carcinoma in liver cirrhosis patients using contrast-enhanced ultrasonography. Hepatol Res. 2012;42:376–84.

    Article  PubMed  Google Scholar 

  83. Shiozawa K, Watanabe M, Takayama R, et al. Evaluation of local recurrence after treatment for hepatocellular carcinoma by contrast-enhanced ultrasonography using Sonazoid: comparison with dynamic computed tomography. J Clin Ultrasound. 2010;38:182–9.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Gastroenterology and Nephrology, Chiba University Graduate School of Medicine, 1-8-1, Inohana, Chuou-ku, Chiba, 260-8670, Japan

    Hitoshi Maruyama, Tadashi Sekimoto & Osamu Yokosuka

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  1. Hitoshi Maruyama
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Correspondence to Hitoshi Maruyama.

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Maruyama, H., Sekimoto, T. & Yokosuka, O. Role of contrast-enhanced ultrasonography with Sonazoid for hepatocellular carcinoma: evidence from a 10-year experience. J Gastroenterol 51, 421–433 (2016). https://doi.org/10.1007/s00535-015-1151-3

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