Objective:To explore the feasibility and efficiency of intraoperative ultrasonography (IOUS) in the cool-tip radiofrequency ablation (RFA) of hepatic carcinoma.Methods:Thirty-one patients of hepatic carcinoma were enrolled in this study.In the process of open-surgical cool-tip radiofrequency ablations,tOUS was applied to assess the hepatic lesions,guide and monitor the process of RFA in real-time.Results:Under the guidance of intraoperative ultresonography,the open surgical RFA in all patients proceed smoothly.Seven additional hepatic lesions were found that were not detected in preoperative imaging.A false positive focal lesion reported by preoperative MRI was accurately ruled out by IOUS.Conclusion:Intraoperative ultrasonography is superior to ordinary imaging techniques in finding missed lesions,avoiding complications such as injuries of bile ducts and vessels.Monitoring the real-time RFA process thereby obviously optimizing the treatment of hepatic carcinoma.