In Korea, radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC) is most widely
used under ultrasonography (US) guidance. With the technical development, small HCCs in
challenging locations can be ablated effectively. Both fusion imaging and contrast-enhanced
US is useful for identifying small inconspicuous HCCs on conventional US, thereby enable us
to conduct successful RFA. Artificial ascites can enhance ultrasonic window and is helpful in
avoiding thermal injury to the surrounding organs. Laparoscopy is also useful for guidance
of RFA for subcapsular HCCs which are difficult to approach percutaneously. (J Liver Cancer
2014;14:89-96)