Percutaneous ethanol injection, radiofrequency and their combination in treatment of hepatocellular carcinoma

Figure 1 Typical HCC in contrast-enhanced sonography of hypervascular HCC before RFA. A: Hypoechoic lesion in the right lobe of the liver on B-mode sonography; B: Blood signals of the lesion on CDFI; C: Intratumoral enhancement in the early arterial phase of contrast-enhanced sonography; D: Hypoechoic lesion compared to the peripheral liver tissue in the late phase.

Figure 2 HCC after RFA. A: Incomplete necrosis of the lesion in the early arterial phase of contrast-enhanced sonography; B: Complete necrosis of the lesion after further RFA.

Figure 3 HCC treated with TACE and RFA. A: Enhancement of the recurrent HCC after resection in the early arterial phase; B: After TACE, lesion restrained with iodine (red arrow) and an un-embolized feeding artery (yellow arrow) in the arterial phase; C: After RFA, no enhancement in the lesion in the early arterial phase (red arrow) and enhancement in the inner part of the lesion (yellow arrows) indicating incomplete necrosis.

Figure 4 Recurrent HCC treated with TACE and RFA. A: hyperechoic lesion on B-mode image; B: Color blood signals on CDFI; C: Irregular echo-free area in the lesion on B-mode image after combined treatment, indicating partial colliquation of the necrotic tumor; D: Color blood signals inside the tumor on CDFI, suggesting incomplete treatment.