CT Versus Sonography for Monitoring Radiofrequency Ablation in a Porcine Liver

Charles, H.; Lee, Fred T.; Gurney, Jonathan M.; Markhardt, B. Keegan; Warner, Thomas F.; Kelcz, Frederick; Mahvi, David M.

doi:10.2214/ajr.175.3.1750705

Cited by 143 publications

(119 citation statements)

References 20 publications

(36 reference statements)

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“…This result was consistent with that of Komorizono and colleagues [26]. A larger tumor usually has a higher rate of local recurrence because it frequently requires multiple overlapping ablations, and targeting of its viable foci is difficult because of lack of clarity of the image obtained between the ablated and nonablated tumor after repeated ablation is performed under sonography [33]. Moreover, a high grade HCC probably has satellite nodules that are away from the main nodule, possibly implying that local recurrence in the same segment can be caused by satellite nodules that may be obscured under sonography.…”

Section: Discussionsupporting

confidence: 90%

Combined percutaneous ethanol injection and mitoxantrone versus radiofrequency ablation in the treatment of hepatocellular carcinoma

Helmy¹,

Abdel-Wahab²,

El-Shamy³

et al. 2016

Med-Science

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New therapeutic choices have been developed for hepatocellular carcinoma, including percutaneous ablation therapy, transarterial chemoembolization, radiation therapy and molecular target therapy. Ablation of liver tumors is currently the main alternative to liver resection. This work aimed at comparing percutaneous combined local injection of ethanol and mitoxantrone versus percutaneous radiofrequency ablation in the treatment of Hepatocellular Carcinoma. This study included 124 patients with hepatocellular carcinoma, they were randomly divided into two groups; group I (64 patients) treated with local injection of ethanol plus mitoxantrone. Group II (60 patients) treated with radiofrequency ablation. Clinical assessment, laboratory evaluation and CT studies were performed to all patients prior to treatment and at 1, 3, 6, and 12 months' post treatment. The percentage of ablation in both groups at 1, 3, 6 and 12 months were 81.3%, 81.3%,76.6 and 71.9% in group I respectively versus 88.3%, 88.3, 85%% and 81.7% in group II respectively with no statistical significant difference between the two groups. Percentage of ablation in small tumors is higher than large tumors in both groups. Side effects and complications are statistically higher in group II than group I. Combination of percutaneous local injection of ethanol and mitoxantrone is comparable to radiofrequency ablation with less frequent complications in the treatment of Hepatocellular Carcinoma when surgical resection or liver transplantation is not amenable or available.

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Section: Discussionsupporting

confidence: 90%

Combined percutaneous ethanol injection and mitoxantrone versus radiofrequency ablation in the treatment of hepatocellular carcinoma

Helmy¹,

Abdel-Wahab²,

El-Shamy³

et al. 2016

Med-Science

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“…37 In addition, it is usually difficult to differentiate treated or untreated tissue under sonography, and the formation of echogenic gas can limit the visibility of tumors during RFA. 21,39 Therefore, overlapping or repeated ablation procedures may lead to inaccurate positioning. The mean session numbers in PEI-treated patients with HCC has been reported to be much greater than that for RFA-treated patients, 19 and this can make it more difficult to achieve local tumor control by PEI compared with RFA.…”

Section: Discussionmentioning

confidence: 99%

Systematic review of randomized trials for hepatocellular carcinoma treated with percutaneous ablation therapies

et al. 2008

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According to the American Association for the Study of Liver Diseases guidelines, percutaneous ethanol injection (PEI) is a safe and highly effective treatment for small hepatocellular carcinomas (HCC) and should be the standard against which any new therapy is compared. The primary purpose of this study was to identify survival benefit of any percutaneous ablation therapy as compared with PEI in the treatment of patients with unresectable HCC. The secondary endpoints were initial tumor response, local tumor progression, and complications. Randomized controlled trials that compared pecutaneous ablative therapies with PEI were included. MEDLINE, the Cochrane Library, CANCERLIT, and manual search from 1978 to July 2008 were used. To control the potential heterogeneity, the random effects model of DerSimonian and Laird was used for a meta-analysis. Egger's test was performed to test a potential publication bias. We identified seven randomized controlled trials (RCTs), but only four RCTs including 652 patients that compared radiofrequency ablation (RFA) with PEI met the inclusion criteria to perform a meta-analysis assessing 3-year survival.

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“…Two or more sessions and a longer ablative duration will be needed to create the area compared to only ablating the main tumor area without adequate safe margin. Unfortunately, repeated insertion and positioning of an electrode may result in inaccurate positioning because the safe margin is difficult to identify after the first treatment under sonogram, probably due to echogenic gas formation by the initial RFA [29] . Inadequate safe margin may be created due to the interference especially for larger tumor that needs repeated sessions.…”

Section: Discussionmentioning

confidence: 99%

Factors for early tumor recurrence of single small hepatocellular carcinoma after percutaneous radiofrequency ablation therapy

Cheng²,

Lai³

et al. 2005

WJG

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AIM:To evaluate the factors affecting the early tumor recurrence within one year in cirrhotic patients having a single small hepatocellular carcinoma (HCC) after complete tumor necrosis by radiofrequency ablation (RFA) therapy. METHODS:Thirty patients with a single small HCC received RFA therapy by a RFA 2000 generator with LeVeen needle. Tri-phase computerized tomogram was followed every 2 to 3 mo after RFA. The clinical effects and tumor recurrence were recorded. RESULTS:The initial complete tumor necrosis rate was 86.7%. Twenty-two patients were followed for more than one year. The local and overall recurrence rates were 13.6% and 36.4%, 33.3% and 56.2%, 46.6% and 56.2% at 12, 24 and 30 mo, respectively. No major complication or procedure-related mortality was found. The risk factors for early local tumor recurrence within one year were larger tumor size, poor pathologic differentiation of tumor cells and advanced tumor staging. The age of patients with new tumor formation within one year was relatively younger (55.1±8.3 vs 66.7±10.8, P = 0.029). CONCLUSION:Large tumor size, poor pathologic differentiation of tumor cells and advanced tumor staging are the risk factors for early local tumor recurrence within one year, and young age is the positive predictor for new tumor formation within one year.

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CT Versus Sonography for Monitoring Radiofrequency Ablation in a Porcine Liver

Abstract: In this animal model, unenhanced CT was an effective way to monitor RF ablation compared with sonography because of increased lesion discrimination, reproducible decreased attenuation during ablation, and improved correlation to pathologic size.

Cited by 143 publications

References 20 publications

Combined percutaneous ethanol injection and mitoxantrone versus radiofrequency ablation in the treatment of hepatocellular carcinoma

Combined percutaneous ethanol injection and mitoxantrone versus radiofrequency ablation in the treatment of hepatocellular carcinoma

Systematic review of randomized trials for hepatocellular carcinoma treated with percutaneous ablation therapies

Factors for early tumor recurrence of single small hepatocellular carcinoma after percutaneous radiofrequency ablation therapy

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