Radiofrequency Thermal Ablation of Hepatocellular Carcinomas

  • Hyo Keun Lim (Department of Radiology and Gastrointestinal Center, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2000.09.27
  • Accepted : 2000.10.17
  • Published : 2000.12.31

Abstract

Although surgical resection remains the best option as potentially curative therapy for hepatocellular carcinoma, radiofrequency thermal ablation has begun to receive much attention as an effective minimally invasive technique for the local control of unresectable malignant hepatic tumors. Most recent radiofrequency devices equipped with a powerful generator and larger needle electrode permit larger thermal lesions, up to 5 cm in diameter, with a single ablation. In this article, the author reviews the technical developments and early clinical results obtained with radiofrequency ablation techniques.

Keywords

Acknowledgement

This paper was supported in part by clinical research fund (G1-00-07) of Gastrointestinal Center, Samsung Medical Center.

References

  1. Colombo M. Hepatocellular carcinoma. J Hepatol 1992;15:225-236 https://doi.org/10.1016/0168-8278(92)90041-M
  2. Tsuzuki T, Sugioka A, Ueda M. Hepatic resection for hepatocellular carcinoma. Surgery 1990;107:511-520
  3. Liver Cancer Study Group of Japan. Primary liver cancer in Japan: clinicopathologic features and results of surgical treatment. Ann Surg 1990;211:277-284
  4. Farmer DG, Rosove MH, Shaked A, Busuttil RW. Current treatment modalities for hepatocellular carcinoma. Ann Surg 1994;219:236-247 https://doi.org/10.1097/00000658-199403000-00003
  5. Livraghi T, Bolondi L, Lazzaroni S, et al. Percutaneous ethanol injection in the treatment of hepatocellular carcinoma in cirrhosis: a study in 207 patients. Cancer 1992;69:925-929 https://doi.org/10.1002/1097-0142(19920215)69:4<925::AID-CNCR2820690415>3.0.CO;2-G
  6. Honda N, Guo Q, Uchida H, Ohishi H, Hiasa Y. Percutaneous hot saline injection therapy for hepatic tumors: an alternative to percutaneous ethanol injection therapy. Radiology 1994;190:53-57 https://doi.org/10.1148/radiology.190.1.8259428
  7. Amin Z, Donald JJ, Masters A, et al. Hepatic metastases: interstitial laser photocoagulation with real-time sonography monitoring and dynamic CT evaluation of treatment. Radiology 1993;187:339-347 https://doi.org/10.1148/radiology.187.2.8475270
  8. Murakami R, Yoshimatsu S, Yamashita Y, Matsukawa T, Takahashi M, Sagara K. Treatment of hepatocellular carcinoma: value of percutaneous microwave coagulation. AJR 1995;164:1159-1164 https://doi.org/10.2214/ajr.164.5.7717224
  9. McGahan JP, Browning PD, Brock JM, Tesluk H. Hepatic ablation using radiofrequency electrocautery. Invest Radiol 1990;25:264-270 https://doi.org/10.1097/00004424-199003000-00011
  10. Goldberg SN, Gazelle GS, Dawson SI, et al. Tissue ablation with radiofrequency using multiprobe arrays. Acad Radiol 1995;2:670-674
  11. Livraghi T, Goldberg SN, Monti F, et al. Saline-enhanced radiofrequency tissue ablation in the treatment of liver metastasis. Radiology 1997;202:205-210 https://doi.org/10.1148/radiology.202.1.8988212
  12. Rossi S, Buscarini E, Garbagnati F, et al. Percutaneous treatment of small hepatic tumors by an expandable RF needle electrode. AJR 1998;170:1015-1022 https://doi.org/10.2214/ajr.170.4.9530052
  13. Curley SA, Izzo F, Delrio P, et al. Radiofrequency ablation of unresectable primary and metastatic hepatic malignancies: results in 123 patients. Ann Surg 1999; 230:1-8 https://doi.org/10.1097/00000658-199907000-00001
  14. Solbiati L, Goldberg SN, Ierace T, et al. Hepatic metastases: percutaneous radio-frequency ablation with cooled-tip electrodes. Radiology 1997;205:367-373 https://doi.org/10.1148/radiology.205.2.9356616
  15. Rossi S, Di Stasi M, Buscarini E, et al. Percutaneous RF interstitial thermal ablation in the treatment of hepatic cancer. AJR 1996;167:759-768 https://doi.org/10.2214/ajr.167.3.8751696
  16. Livraghi T, Goldberg SN, Lazzaroni S, Meloni F, Solbiati L, Gazelle GS. Small hepatocellular carcinoma: treatment with radio-frequency ablation versus ethanol injection. Radiology 1999;210:655-661 https://doi.org/10.1148/radiology.210.3.r99fe40655
  17. Livraghi T, Goldberg SN, Lazzaroni S, et al. Hepatocellular carcinoma: radio-frequency ablation of medium and large lesions. Radiology 2000; 214:761-768 https://doi.org/10.1148/radiology.214.3.r00mr02761
  18. Goldberg SN, Solbiati L, Hahn PF et al. Large-volume tissue ablation with radiofrequency by using a clustered, internally cooled electrode: laboratory and clinical experience in liver metastases. Radiology 1998;209:371-379 https://doi.org/10.1148/radiology.209.2.9807561
  19. Choi D, Lim HK, Park JM, et al. An experimental study on hepatic ablation using an expandable radiofrequency needle electrode. J of Korean Radiol Soc 1999;41:1127-1132 https://doi.org/10.3348/jkrs.1999.41.6.1127
  20. Choi D, Lim HK, Kim SH, et al. Radiofrequency ablation of small heaptocellular carcinoma: early experience of efficacy and safety. J of Korean Radiol Soc 2000;42:743-749 https://doi.org/10.3348/jkrs.2000.42.5.743
  21. Hornback NB. Historical aspects of hyperthermia in cancer therapy. Radiol Clin North Am 1989;27:481-488 https://doi.org/10.1016/S0033-8389(22)02133-9
  22. Coley WB. The treatment of malignant tumors by repeated innoculations of erysipelas, with a report of ten original cases. Am J Med Sci 1893;105:487-492 https://doi.org/10.1097/00000441-189305000-00001
  23. Rosomoff Hl, Carroll F, Brown J, Sheptak T. Percutaneous radiofrequency cervical cordotomy technique. J Neurosurgery 1965;23:639-644 https://doi.org/10.3171/jns.1965.23.6.0639
  24. LeVenn HH, Ahmed N, Piccone VA, Shugaar S, Falk G. Radiofrequency therapy: clinical experience. Ann N Y Acad Sci 1980;335:362-371 https://doi.org/10.1111/j.1749-6632.1980.tb50761.x
  25. Seki T, Wakabayashi M, Nakagawa T, et al. Ultrasonically guided percutaneous microwave coagulation therapy for small hepatocellular carcinoma. Cancer 1994;74:817-825 https://doi.org/10.1002/1097-0142(19940801)74:3<817::AID-CNCR2820740306>3.0.CO;2-8
  26. Dickson JA, Calderwood SK. Temperature range and selective sensitivity of tumors to hyperthermia: a critical review. Ann N Y Acad Sci 1980;335:180-205 https://doi.org/10.1111/j.1749-6632.1980.tb50749.x
  27. Hill RP and Hunt JW. Hyperthermia. In Tannock IF, Hill RF, eds. The Basic Science of Oncology. New York: Pergamon Press, 1987:337-357
  28. Allain JC, LeLouis M, Bailey AJ, Delaunay A. Isometric tension developed during heating of collagen tissues: relationship with collagen cross-linking. Biochimica et Biophysica Acta 1978;533:147-155 https://doi.org/10.1016/0005-2795(78)90558-5
  29. Haines DE, Verow AF. Observations on the electrode-tissue interface temperature and effect on electrical impendance during radiofrequency ablation of ventricular myocardium. Circ 1990;82:1034-1038 https://doi.org/10.1161/01.CIR.82.3.1034
  30. Goldberg SN, Hahn PF, Tanabe KK, et al. Percutaneous radiofrequency tissue ablation: does perfusion-mediated tissue cooling limit coagulation necrosis? J Vasc Interv Radiol 1998;9:101-111 https://doi.org/10.1016/S1051-0443(98)70491-9
  31. Patterson EJ, Scudamore CH, Owen DA, Nagy AG, Buczkowski AK. Radiofrequency ablation of porcine liver in vivo: effects of blood flow and treatement time on lesion size. Annals of Surgery 1998;227:559-565 https://doi.org/10.1097/00000658-199804000-00018
  32. Goldberg SN, Hahn PF, Halpern EF, Fogle RM, Gazelle GS. Radio-frequency tissue ablation: effect of pharmacologic modulation of blood flow on coagulation diameter. Radiology 1998;209:761-767 https://doi.org/10.1148/radiology.209.3.9844671
  33. Goldberg SN, Gazelle GS, Solbiati L, et al. Ablation of liver tumors using percutaneous RF therapy. AJR 1998;170:1023-1028 https://doi.org/10.2214/ajr.170.4.9530053
  34. Choi D, Lim HK, Lee WJ, et al. Evaluation of therapeutic response in hepatocellular carcinoma treated with percutaneous radio-frequency ablation: usefulness of power Doppler US with a microbubble contrast agent-preliminary results. Radiology 2000;217:558-563 https://doi.org/10.1148/radiology.217.2.r00oc07558
  35. Lim HK. Radiofrequency ablation of hepatocellular carcinoma. Proceedings of the 4th Asian Pacific Congress of Cardiovascular and Interventional Radiology, 2000;120-122