Percutaneous radiofrequency ablation for hepatic malignancies
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To study the therapeutic efficay of percutaneous radiofrequency ablation (PRFA) for hepatic malignancies and to define its indications and its criteria of the curative effect.
In 100 patients with histologically or clinically confirmed hepatocellular carcinoma (HCC) or liver metastases we performed PRFA under ultrasound guidance using LeVeen multipolar array needle electrode and RF 2000 generator. All patients were followed to identify complications and to assess treatment response.
PRFA was performed in 76 patients with HCC and in 24 with liver metastases. The Alpha-fetoprotein (AFP) levels of the AFP positive HCC patients with inoperable small HCCs decreased to normal in 75.0% (21/28) and decreased markedly in 21.4% (6/28). Complete necrosis of small hepatic malignancies, documented by magnetic resonance imaging (MRI) was achieved in 85.9% (61/71). If the tumor shows iso-or hyper-intensity on T1-weighted images, and relative hypointensity on T2-weighted images, and no enhanced intensity on dynamic contrast-enhanced MR imaging, it is considered completely coagulated.
PRFA is a novel local thermal palliative therapy for small hepatic malignancies that is minimally invasive, safe and effective. In patients with large lesions it can be combined with transarterial chemoembolization (TACE). Critera for curative treatment are normalization of serum AFP and/or MRI or CT scan findings showing complete necrosis.
Key wordsneoplasm iiver surgery radiofrequency magnetic resonance imaging
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