Fig. 3. RF ablation using AA method via gastrohepatic (lesser sac) route in 63-year-old woman.

A. Sagittal US image depicts hypoechoic HCC (arrows) in segment 3 near stomach (S). B. Photograph shows inserted angiosheath (arrowhead) through gastrohepatic route and needle electrode into target tumor. C. Sagittal US image during procedure demonstrates transient hyperechoic cloud (asterisk) and AA (arrow) in lesser sac between liver and stomach (S). D. Immediate follow-up contrast-enhanced CT image reveals low-attenuated RF ablation zone (asterisk) that sufficiently covers index tumor as well as intact adjacent gastric wall (arrow). AA = artificial ascites, HCC = hepatocellular carcinoma, RF = radiofrequency, US = ultrasound