AbstractAimTo evaluate the role of Sonazoid enhanced ultrasound assistant laparoscopic radiofrequency ablation in treating liver malignancy.MethodsConsecutive patients are recruited. Rates of complication and postoperative length of stay are compared between the study and control groups. Progression‐free survival (PFS) of colorectal liver metastasis (CRLM) after ablation are compared. Complete ablation rates are compared and optimal tumor size is calculated by ROC curve analysis. Risk factors of incomplete ablation are determined by logistic regression analysis.ResultsTotally 73 patients with 153 lesions were included. No significant differences in the rate of complication were found between the study and control groups. PFS of CRLM in laparoscopic, intraoperative CEUS, and laparoscopic CEUS groups are all longer than their control groups. Complete ablation rates of laparoscopic, intraoperative CEUS, and laparoscopic CEUS groups are all higher than in their control groups with statistical significance. A tumor size of 2.15 cm is determined to be the optimal cut‐off with the area under the ROC curve of 0.854, 95% CI (0.764, 0.944),p= 0.001. In logistic regression analysis, tumor size [OR 20.425, 95% CI (3.136, 133.045),p= 0.002] and location of segments VII and VIII [OR 9.433, 95% CI (1.364, 65.223),p= 0.023] are calculated to be the risk factors of incomplete ablation, meanwhile, intraoperative CEUS shows to be a protective factor in univariate analysis [OR 0.110, 95% CI (0.013, 0.915),p= 0.041].ConclusionSonazoid‐enhanced ultrasound assistant laparoscopic radiofrequency ablation is safe and effective to treat liver malignancy. We should pay attention to the ablation planning of larger tumors and tumors in special locations.