Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Angled Cool-Tip Electrode for Radiofrequency Ablation of Small Superficial Subcapsular Tumors in the Liver: A Feasibility Study

  • Park, Sung Il (Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine) ;
  • Kim, Il Jung (Department of Radiology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Lee, Shin Jae (Department of Radiology, CHA Bundang Medical Center, CHA University) ;
  • Shin, Min Woo (Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine) ;
  • Shin, Won Sun (Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine) ;
  • Chung, Yong Eun (Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine) ;
  • Kim, Gyoung Min (Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine) ;
  • Kim, Man Deuk (Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine) ;
  • Won, Jong Yun (Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine) ;
  • Lee, Do Yun (Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine) ;
  • Choi, Jin Sub (Department of Surgery, Severance Hospital, Yonsei University College of Medicine) ;
  • Han, Kwang-Hyub (Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine)
  • Received : 2015.09.04
  • Accepted : 2016.06.10
  • Published : 2016.09.01
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Abstract

Objective: To evaluate the feasibility of angled cool-tip electrode for radiofrequency ablation of small superficial subcapsular liver tumors abutting abdominal wall, in order to traverse normal liver parenchyma, and thereby, obtain favorable configuration of ablation margin. Materials and Methods: In this study, we retrospectively analyzed 15 small superficial subcapsular liver tumors abutting abdominal wall in 15 patients, treated with radiofrequency ablation from March 2013 to June 2015 using a cool-tip electrode manually modified to create $25-35^{\circ}$ angle at the junction between exposed and insulated segments. The tumors were hepatocellular carcinoma (n = 13) and metastases (n = 2: cholangiocellular carcinoma and rectosigmoid cancer), with maximum diameter of 10-26 mm (mean, $15.68{\pm}5.29mm$). Under ultrasonographic guidance, the electrode tip was advanced to the depth of the tumors' epicenter about 1 cm from the margin. The tip was re-directed to penetrate the tumor for radiofrequency ablation. Minimal ablation margin was measured at immediate post-treatment CT. Radiological images and medical records were evaluated for success rate, length of minimal ablation margin and complications. Results: Technical success rate of obtaining complete necrosis of the tumors was 100%, with no procedure-related complication. Minimal ablation margin ranged from 3-12 mm (mean, $7.07{\pm}2.23mm$). CT/MRI follow-up at 21-1022 days (mean, $519.47{\pm}304.51$ days) revealed no local recurrence, but distant recurrence in 9 patients. Conclusion: Using an angled cool-tip electrode for radiofrequency ablation of small superficial subcapsular tumors abutting abdominal wall may be a feasible technique for obtaining adequate ablation margin and lower complication rate.

Keywords

Acknowledgement

Grant : BK21플러스

Supported by : 연세대학교

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