Radiofrequency Thermal Ablation of Hepatocellular Carcinoma

Abstract

In this chapter, the principles of radiofrequency (RF) thermal ablation and the techniques currently used in the treatment of hepatocellular carcinoma (HCC) are discussed. Our group was the first to propose, in 1990, the possibility of employing interstitial hyperthermia to percutaneous ablation of liver tumors. In the last few years, technological improvements have been introduced in order to obtain a larger volume of necrosis, to make the procedure more effective, to shorten the time required for the therapy, to enhance the patient’s compliance and to reduce the economic cost. Particularly, new types of needle electrodes, such as expandable electrodes and cooled tip electrodes have entered into clinical use. With recent experience, association of radiofrequency thermal ablation with segmental transcatheter arterial embolization has also been used for treatment of large HCC lesions. Currently, with the use of expandable needles, most HCC tu-mors up to 3.5 cm can be ablated in a single session. By combining RF thermal ablation and arterial em-bolization, tumors up to 6.5 cm can be effectively treated.