PURPOSE: This study aimed to assess the feasibility of performing ultrasonography (US)-guided percutaneous radiofrequency (RF) ablation on patients with hepatocellular carcinoma (HCC) and identify causes of procedure infeasibility and its predisposing conditions. MATERIALS AND METHODS: A total of 109 consecutive patients (male:female=86:23; mean 59.9 years) with 136 HCCs (mean 1.8 cm) who had been referred for planning US were analyzed. We evaluated overall procedure feasibility as well as specific factors relating to feasibility, including inability to visualize the tumor with US and factors relating to safety of the procedure. RESULTS: The use of percutaneous RF ablation was concluded as infeasible for 45 tumors (33.1%). Reasons for infeasibility included tumor invisibility (n=32), a high risk of collateral thermal injury (n=5), absence of a safe electrode path (n=5) and a combination of factors (n=3). Among 136 tumors, 36(26.5%) were invisible due to isoechogenicity (n=16), indiscrimination from surrounding cirrhotic nodules (n=10) or an unfavorable location (n=10). Tumor invisibility was significantly attributed to a small tumor size (P<0.001, risk ratio=0.823) and the presence of macronodular cirrhosis (P=0.006, risk ratio=4.117). Seven patients with invisible tumors were treated with RF ablation after follow-up (n=4) or with use of adjacent structures as landmarks (n=3). Ultimately, 65 of 109 patients were treated with percutaneous RF ablation. CONCLUSIONS: US-guided percutaneous RF ablation for HCC was feasible in about two-thirds of candidates. Infeasibility was mostly due to inability to visualize the tumor with US, especially for patients with smaller tumor and macronodular cirrhosis.
PURPOSE: This study aimed to assess the feasibility of performing ultrasonography (US)-guided percutaneous radiofrequency (RF) ablation on patients with hepatocellular carcinoma (HCC) and identify causes of procedure infeasibility and its predisposing conditions. MATERIALS AND METHODS: A total of 109 consecutive patients (male:female=86:23; mean 59.9 years) with 136 HCCs (mean 1.8 cm) who had been referred for planning US were analyzed. We evaluated overall procedure feasibility as well as specific factors relating to feasibility, including inability to visualize the tumor with US and factors relating to safety of the procedure. RESULTS: The use of percutaneous RF ablation was concluded as infeasible for 45 tumors (33.1%). Reasons for infeasibility included tumor invisibility (n=32), a high risk of collateral thermal injury (n=5), absence of a safe electrode path (n=5) and a combination of factors (n=3). Among 136 tumors, 36(26.5%) were invisible due to isoechogenicity (n=16), indiscrimination from surrounding cirrhotic nodules (n=10) or an unfavorable location (n=10). Tumor invisibility was significantly attributed to a small tumor size (P<0.001, risk ratio=0.823) and the presence of macronodular cirrhosis (P=0.006, risk ratio=4.117). Seven patients with invisible tumors were treated with RF ablation after follow-up (n=4) or with use of adjacent structures as landmarks (n=3). Ultimately, 65 of 109 patients were treated with percutaneous RF ablation. CONCLUSIONS: US-guided percutaneous RF ablation for HCC was feasible in about two-thirds of candidates. Infeasibility was mostly due to inability to visualize the tumor with US, especially for patients with smaller tumor and macronodular cirrhosis.
Authors: Marco Calandri; Valeria Ruggeri; Patrizia Carucci; Stefano Mirabella; Andrea Veltri; Paolo Fonio; Carlo Gazzera Journal: Radiol Med Date: 2019-07-03 Impact factor: 3.469
Authors: Mohamed A Abbass; Allison-Joy Garbo; Neeraja Mahalingam; Jakob K Killin; T Douglas Mast Journal: IEEE Trans Ultrason Ferroelectr Freq Control Date: 2018-06-14 Impact factor: 2.725
Authors: Philippa Meershoek; Nynke S van den Berg; Jacob Lutjeboer; Mark C Burgmans; Rutger W van der Meer; Catharina S P van Rijswijk; Matthias N van Oosterom; Arian R van Erkel; Fijs W B van Leeuwen Journal: Eur J Radiol Open Date: 2021-07-08