No-Touch Radiofrequency Ablation of VX2 Hepatic Tumors <i>In Vivo</i> in Rabbits: A Proof of Concept Study

Kim, Tae-Hyung; Choi, Hyoung In; Kim, Bo Ram; Kang, Ji Hee; Nam, Ju Gang; Park, Sae Jin; Lee, Seung–Hyun; Yoon, Jeong Hee; Lee, Dong Hoon; Joo, Ijin; Lee, Jeong Min

doi:10.3348/kjr.2018.19.6.1099

Cited by 9 publications

(6 citation statements)

References 43 publications

(62 reference statements)

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“…NT-RFA : bipolar RFA was performed using TICW electrodes and the same generator unit used in the conventional RFA group. For the NT-RFA technique, the two tines of TICW electrodes were inserted into the perimeter of the index tumor (generally 3–5 mm from the margin of the target tumor) at an inter-electrode distance of 2–3 cm, depending on tumor size, under the guidance of real-time US-CT/MR fusion imaging [ 14 15 17 21 ]. An example case is shown in Figure 2 .…”

Section: Methodsmentioning

confidence: 99%

No-Touch vs. Conventional Radiofrequency Ablation Using Twin Internally Cooled Wet Electrodes for Small Hepatocellular Carcinomas: A Randomized Prospective Comparative Study

et al. 2021

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Objective This study aimed to compare the efficacy between no-touch (NT) radiofrequency ablation (RFA) and conventional RFA using twin internally cooled wet (TICW) electrodes in the bipolar mode for the treatment of small hepatocellular carcinomas (HCC). Materials and Methods In this single-center, two-arm, parallel-group, prospective randomized controlled study, we performed a 1:1 random allocation of eligible patients with HCCs to receive NT-RFA or conventional RFA between October 2016 and September 2018. The primary endpoint was the cumulative local tumor progression (LTP) rate after RFA. Secondary endpoints included technical conversion rates of NT-RFA, intrahepatic distance recurrence, extrahepatic metastasis, technical parameters, technical efficacy, and rates of complications. Cumulative LTP rates were analyzed using Kaplan-Meier analysis and the Cox proportional hazard regression model. Considering conversion cases from NT-RFA to conventional RFA, intention-to-treat and as-treated analyses were performed. Results Enrolled patients were randomly assigned to the NT-RFA group (37 patients with 38 HCCs) or the conventional RFA group (36 patients with 38 HCCs). Among the NT-RFA group patients, conversion to conventional RFA occurred in four patients (10.8%, 4/37). According to intention-to-treat analysis, both 1- and 3-year cumulative LTP rates were 5.6%, in the NT-RFA group, and they were 11.8% and 21.3%, respectively, in the conventional RFA group ( p = 0.073, log-rank). In the as-treated analysis, LTP rates at 1 year and 3 years were 0% and 0%, respectively, in the NT-RFA group sand 15.6% and 24.5%, respectively, in the conventional RFA group ( p = 0.004, log-rank). In as-treated analysis using multivariable Cox regression analysis, RFA type was the only significant predictive factor for LTP (hazard ratio = 0.061 with conventional RFA as the reference, 95% confidence interval = 0.000–0.497; p = 0.004). There were no significant differences in the procedure characteristics between the two groups. No procedure-related deaths or major complications were observed. Conclusion NT-RFA using TICW electrodes in bipolar mode demonstrated significantly lower cumulative LTP rates than conventional RFA for small HCCs, which warrants a larger study for further confirmation.

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Section: Methodsmentioning

confidence: 99%

No-Touch vs. Conventional Radiofrequency Ablation Using Twin Internally Cooled Wet Electrodes for Small Hepatocellular Carcinomas: A Randomized Prospective Comparative Study

et al. 2021

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“…The rate of successful no-touch RFA, defined as performing RFA without violation of the tumor during the procedure, was also recorded. In addition, technical success of RFA was de-no-touch RFA provided good local tumor control and a lower rate of recurrence (11,12). Several clinical studies have also reported that no-touch RFA may provide an LTP rate as low as 6% at 5 years and that it also has the potential to prevent intrasubsegmental recurrence (10,13).…”

Section: Rfa Procedures and Follow-upmentioning

confidence: 99%

Outcome of No-Touch Radiofrequency Ablation for Small Hepatocellular Carcinoma: A Multicenter Clinical Trial

Lee¹,

Lee²,

Kim³

et al. 2021

Radiology

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Background:Recently introduced no-touch radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC) has the potential to improve local tumor control.Purpose: To evaluate midterm clinical outcomes of monopolar no-touch RFA in single HCCs 2.5 cm or smaller. Materials and Methods:In this multicenter clinical trial (ClinicalTrials.gov: NCT03375281), participants were evaluated for eligibility from November 2017 to January 2019. Patients with single HCCs 2.5 cm or smaller planning to be treated with no-touch RFA were enrolled. The rate of successful no-touch RFA, defined as performing RFA without violation of the tumor itself, was recorded. Multivariable logistic regression analysis was used to determine associated factors for failure of no-touch RFA. Development of major complication after no-touch RFA was also recorded. Cumulative incidence of local tumor progression (LTP) and recurrence-free survival were estimated by using the Kaplan-Meier method.Results: A total of 140 participants (mean age, 62 years  9 [standard deviation]; 106 men) were evaluated. No-touch RFA was successfully performed in 128 participants (128 of 140; 91.4%), and conversion to tumor puncture RFA was undertaken in 12 participants because of the lack of a safe access route. By using either no-touch RFA or conversion to tumor puncture RFA, all participants achieved technical success of RFA, which was defined as complete coverage of target tumor by ablation zone. Insufficient peritumoral parenchyma (5 mm width around more than half portion of tumor; odds ratio, 74; 95% CI: 18, 309; P  .001) was the only significant predictive factor for failure of the no-touch technique. Among the 140 participants, LTP developed in two participants, and the estimated 1-and 2-year cumulative incidence of LTP was 0.7% and 1.6%, respectively. The estimated 1-and 2-year recurrence-free survival was 82.8% and 74.1%, respectively. Conclusion:No-touch radiofrequency ablation was an effective and safe treatment method for small hepatocellular carcinomas (2.5 cm), with 1.6% of cumulative incidence of local tumor progression at 2 years.

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“…The first advantage is the ablative volume could be selectively The second advantage is that ATA greatly reduces the heat sink effect and, in turn, increases local heat accumulation and ensure irreversible cell damage in the tumor. Previous reports 15,27,28 stated that the heat sink effect caused by intratumoral or peritumoral blood vessels was correlated with the incidence of LTP. Some researchers [18][19][20] have proposed that ablation of the feeding artery may prevent LTP and intrahepatic tumor recurrence by decreasing the heat sink effect.…”

Section: Discussionmentioning

confidence: 95%

Comparison of anatomical thermal ablation and routine thermal ablation for hepatocellular carcinoma≤50 mm: A propensity score matching

Long

et al. 2022

Hepatology Research

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Aim The present study was to evaluated the clinical value of anatomical thermal ablation to treat hepatocellular carcinoma compared with routine thermal ablation. Methods Hepatocellular carcinoma patients with tumor diameter ≤50 mm treated by thermal ablation at our center were retrospectively enrolled from October 2015 to December 2018. Enrolled patients were grouped into the anatomical ablation group and routine ablation group, respectively. To minimize the effects of potential confounders from selection bias, a propensity score matching was carried out. Technical efficacy, recurrence and survivals rates were compared. Results Altogether 101 patients (119 lesions) were grouped into the anatomical ablation group and 101 patients (131 lesions) into the routine ablation group. The ablation zone volume of the anatomical ablation group was 36.8 (2.5–176.9) ml, significantly larger than that of the routine ablation group (28.5 [28.5 (2.8–184.3) ml] (p = 0.005)). Adjusted with propensity score matching, The 1‐, 2‐, and 3‐year local recurrence rates were 0.0%, 0.0%, and 0.0% for the anatomical ablation group and 6.9%, 10.1%, and 10.1% for the routine ablation group, respectively (p = 0.013). The cumulative 1‐, 2‐, and 3‐year progression‐free survival rates were 93.4%, 82.7%, and 79.0% for the anatomical ablation group, 74.2%, 56.9%, and 51.6% for the routine ablation group (p = 0.001). Conclusions Anatomical ablation could be a favorable ablation strategy to improve therapeutic effect of thermal ablation for HCC with visible feeding vessels and reserved liver function.

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No-Touch Radiofrequency Ablation of VX2 Hepatic Tumors In Vivo in Rabbits: A Proof of Concept Study

Cited by 9 publications

References 43 publications

No-Touch vs. Conventional Radiofrequency Ablation Using Twin Internally Cooled Wet Electrodes for Small Hepatocellular Carcinomas: A Randomized Prospective Comparative Study

No-Touch vs. Conventional Radiofrequency Ablation Using Twin Internally Cooled Wet Electrodes for Small Hepatocellular Carcinomas: A Randomized Prospective Comparative Study

Outcome of No-Touch Radiofrequency Ablation for Small Hepatocellular Carcinoma: A Multicenter Clinical Trial

Comparison of anatomical thermal ablation and routine thermal ablation for hepatocellular carcinoma≤50 mm: A propensity score matching

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