Korean Journal of Radiology

  • 제19권6호
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  • Pages.1099-1109
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  • 2018
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  • 1229-6929(pISSN)
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  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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No-Touch Radiofrequency Ablation of VX2 Hepatic Tumors In Vivo in Rabbits: A Proof of Concept Study

  • Kim, Tae-Hyung (Department of Radiology, Seoul National University Hospital) ;
  • Choi, Hyoung In (Department of Radiology, Seoul National University Hospital) ;
  • Kim, Bo Ram (Department of Radiology, Seoul National University Hospital) ;
  • Kang, Ji Hee (Department of Radiology, Seoul National University Hospital) ;
  • Nam, Ju Gang (Department of Radiology, Seoul National University Hospital) ;
  • Park, Sae Jin (Department of Radiology, Seoul National University Hospital) ;
  • Lee, Seunghyun (Department of Radiology, Seoul National University Hospital) ;
  • Yoon, Jeong Hee (Department of Radiology, Seoul National University Hospital) ;
  • Lee, Dong Ho (Department of Radiology, Seoul National University Hospital) ;
  • Joo, Ijin (Department of Radiology, Seoul National University Hospital) ;
  • Lee, Jeong Min (Department of Radiology, Seoul National University Hospital)
  • 투고 : 2018.01.07
  • 심사 : 2018.07.23
  • 발행 : 2018.12.01
⟨ 이전 논문 다음 논문 ⟩

초록

Objective: In a proof of concept study, we compared no-touch radiofrequency ablation (NtRFA) in bipolar mode with conventional direct tumor puncture (DTP) in terms of local tumor control (LTC), peritoneal seeding, and tumorigenic factors, in the rabbit VX2 subcapsular hepatic tumor model. Materials and Methods: Sixty-two rabbits with VX2 subcapsular hepatic tumors were divided into three groups according to the procedure: DTP-RFA (n = 25); NtRFA (n = 25); and control (n = 12). Each of the three groups was subdivided into two sets for pathologic analysis (n = 24) or computed tomography (CT) follow-up for 6 weeks after RFA (n = 38). Ultrasonography-guided DTP-RFA and NtRFA were performed nine days after tumor implantation. LTC was defined by either achievement of complete tumor necrosis on histopathology or absence of local tumor progression on follow-up CT and autopsy. Development of peritoneal seeding was also compared among the groups. Serum hepatocyte growth factor (HGF), vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6) were measured via ELISA (Elabscience Biotechnology Co.) after RFA for tumorigenic factor evaluation. Results: Regarding LTC, there was a trend in NtRFA (80%, 20/25) toward better ablation than in DTP-RFA (56%, 14/25) (p = 0.069). Complete tumor necrosis was achieved in 54.5% of DTP-RFA (6/11) and 90.9% of NtRFA (10/11). Peritoneal seeding was significantly more common in DTP-RFA (71.4%, 10/14) than in NtRFA (21.4%, 3/14) (p = 0.021) or control (0%). Elevations of HGF, VEGF or IL-6 were not detected in any group. Conclusion: No-touch radiofrequency ablation led to lower rates of peritoneal seeding and showed a tendency toward better LTC than DTP-RFA.

키워드

과제정보

연구 과제 주관 기관 : Korea Health Industry Development Institute (KHIDI)

참고문헌

  1. Bruix J, Sherman M; American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma: an update. Hepatology 2011;53:1020-1022 https://doi.org/10.1002/hep.24199
  2. Hocquelet A, Aube C, Rode A, Cartier V, Sutter O, Manichon AF, et al. Comparison of no-touch multi-bipolar vs. monopolar radiofrequency ablation for small HCC. J Hepatol 2017;66:67-74 https://doi.org/10.1016/j.jhep.2016.07.010
  3. Lu DS, Yu NC, Raman SS, Limanond P, Lassman C, Murray K, et al. Radiofrequency ablation of hepatocellular carcinoma: treatment success as defined by histologic examination of the explanted liver. Radiology 2005;234:954-960 https://doi.org/10.1148/radiol.2343040153
  4. Brillet PY, Paradis V, Brancatelli G, Rangheard AS, Consigny Y, Plessier A, et al. Percutaneous radiofrequency ablation for hepatocellular carcinoma before liver transplantation: a prospective study with histopathologic comparison. AJR Am J Roentgenol 2006;186(5 Suppl):S296-S305 https://doi.org/10.2214/AJR.04.1927
  5. Seror O, N'Kontchou G, Nault JC, Rabahi Y, Nahon P, Ganne-Carrie N, et al. Hepatocellular carcinoma within Milan criteria: no-touch multibipolar radiofrequency ablation for treatmentlong-term results. Radiology 2016;280:981
  6. Dodd GD 3rd, Frank MS, Aribandi M, Chopra S, Chintapalli KN. Radiofrequency thermal ablation: computer analysis of the size of the thermal injury created by overlapping ablations. AJR Am J Roentgenol 2001;177:777-782 https://doi.org/10.2214/ajr.177.4.1770777
  7. Lee J, Lee JM, Yoon JH, Lee JY, Kim SH, Lee JE, et al. Percutaneous radiofrequency ablation with multiple electrodes for medium-sized hepatocellular carcinomas. Korean J Radiol 2012;13:34-43 https://doi.org/10.3348/kjr.2012.13.1.34
  8. Seror O, N'Kontchou G, Van Nhieu JT, Rabahi Y, Nahon P, Laurent A, et al. Histopathologic comparison of monopolar versus no-touch multipolar radiofrequency ablation to treat hepatocellular carcinoma within Milan criteria. J Vasc Interv Radiol 2014;25:599-607 https://doi.org/10.1016/j.jvir.2013.11.025
  9. Patel PA, Ingram L, Wilson ID, Breen DJ. No-touch wedge ablation technique of microwave ablation for the treatment of subcapsular tumors in the liver. J Vasc Interv Radiol 2013;24:1257-1262 https://doi.org/10.1016/j.jvir.2013.04.014
  10. Lee MW, Raman SS, Asvadi NH, Siripongsakun S, Hicks RM, Chen J, et al. Radiofrequency ablation of hepatocellular carcinoma as bridge therapy to liver transplantation: a 10-year intention-to-treat analysis. Hepatology 2017;65:1979-1990 https://doi.org/10.1002/hep.29098
  11. Pompili M, Francica G, Ponziani FR, Iezzi R, Avolio AW. Bridging and downstaging treatments for hepatocellular carcinoma in patients on the waiting list for liver transplantation. World J Gastroenterol 2013;19:7515-7530 https://doi.org/10.3748/wjg.v19.i43.7515
  12. Kumar N, Gaba RC, Knuttinen MG, Omene BO, Martinez BK, Owens CA, et al. Tract seeding following radiofrequency ablation for hepatocellular carcinoma: prevention, detection, and management. Semin Intervent Radiol 2011;28:187-192 https://doi.org/10.1055/s-0031-1280662
  13. Wang S, Mei XG, Goldberg SN, Ahmed M, Lee JC, Gong W, et al. Does thermosensitive liposomal vinorelbine improve endpoint survival after percutaneous radiofrequency ablation of liver tumors in a mouse model? Radiology 2016;279:762-772 https://doi.org/10.1148/radiol.2015150787
  14. Bulvik BE, Rozenblum N, Gourevich S, Ahmed M, Andriyanov AV, Galun E, et al. Irreversible electroporation versus radiofrequency ablation: a comparison of local and systemic effects in a small-animal model. Radiology 2016;280:413-424 https://doi.org/10.1148/radiol.2015151166
  15. Ahmed M, Kumar G, Moussa M, Wang Y, Rozenblum N, Galun E, et al. Hepatic radiofrequency ablation-induced stimulation of distant tumor growth is suppressed by c-Met inhibition. Radiology 2016;279:103-117 https://doi.org/10.1148/radiol.2015150080
  16. Rozenblum N, Zeira E, Scaiewicz V, Bulvik B, Gourevitch S, Yotvat H, et al. Oncogenesis: an "off-target" effect of radiofrequency ablation. Radiology 2015 Mar 30 [Epub ahead of print]. https://doi.org/10.1148/radiol.15141695
  17. Rozenblum N, Zeira E, Bulvik B, Gourevitch S, Yotvat H, Galun E, et al. Radiofrequency ablation: inflammatory changes in the periablative zone can induce global organ effects, including liver regeneration. Radiology 2015;276:416-425 https://doi.org/10.1148/radiol.15141918
  18. Maruyama H, Matsutani S, Saisho H, Kamiyama N, Mine Y, Hirata T, et al. Sonographic shift of hypervascular liver tumor on blood pool harmonic images with definity: time-related changes of contrast-enhanced appearance in rabbit VX2 tumor under extra-low acoustic power. Eur J Radiol 2005;56:60-65 https://doi.org/10.1016/j.ejrad.2005.04.004
  19. Galasko CS, Muckle DS. Intrasarcolemmal proliferation of the VX2 carcinoma. Br J Cancer 1974;29:59-65 https://doi.org/10.1038/bjc.1974.7
  20. Bimonte S, Leongito M, Piccirillo M, de Angelis C, Pivonello C, Granata V, et al. Radio-frequency ablation-based studies on VX2rabbit models for HCC treatment. Infect Agent Cancer 2016;11:38 https://doi.org/10.1186/s13027-016-0082-9
  21. Behm B, Di Fazio P, Michl P, Neureiter D, Kemmerling R, Hahn EG, et al. Additive antitumour response to the rabbit VX2 hepatoma by combined radio frequency ablation and toll like receptor 9 stimulation. Gut 2016;65:134-143 https://doi.org/10.1136/gutjnl-2014-308286
  22. Jiang T, Zhang X, Ding J, Duan B, Lu S. Inflammation and cancer: inhibiting the progression of residual hepatic VX2 carcinoma by anti-inflammatory drug after incomplete radiofrequency ablation. Int J Clin Exp Pathol 2015;8:13945-13956
  23. Ke S, Ding XM, Kong J, Gao J, Wang SH, Cheng Y, et al. Low temperature of radiofrequency ablation at the target sites can facilitate rapid progression of residual hepatic VX2 carcinoma. J Transl Med 2010;8:73 https://doi.org/10.1186/1479-5876-8-73
  24. Ahmed M, Solbiati L, Brace CL, Breen DJ, Callstrom MR, Charboneau JW, et al.; International Working Group on Image-Guided Tumor Ablation; Interventional Oncology Sans Frontieres Expert Panel; Technology Assessment Committee of the Society of Interventional Radiology; Standard of Practice Committee of the Cardiovascular and Interventional Radiological Society of Europe. Image-guided tumor ablation: standardization of terminology and reporting criteria--a 10-year update. J Vasc Interv Radiol 2014;25:1691-1705.e4 https://doi.org/10.1016/j.jvir.2014.08.027
  25. Imamura J, Tateishi R, Shiina S, Goto E, Sato T, Ohki T, et al. Neoplastic seeding after radiofrequency ablation for hepatocellular carcinoma. Am J Gastroenterol 2008;103:3057-3062 https://doi.org/10.1111/j.1572-0241.2008.02153.x
  26. Wu H, Wilkins LR, Ziats NP, Haaga JR, Exner AA. Real-time monitoring of radiofrequency ablation and postablation assessment: accuracy of contrast-enhanced US in experimental rat liver model. Radiology 2014;270:107-116 https://doi.org/10.1148/radiol.13121999
  27. Chang W, Lee JM, Lee SM, Han JK. No-touch radiofrequency ablation: a comparison of switching bipolar and switching monopolar ablation in ex vivo bovine liver. Korean J Radiol 2017;18:279-288 https://doi.org/10.3348/kjr.2017.18.2.279
  28. Yoon JH, Lee JM, Hwang EJ, Hwang IP, Baek J, Han JK, et al. Monopolar radiofrequency ablation using a dual-switching system and a separable clustered electrode: evaluation of the in vivo efficiency. Korean J Radiol 2014;15:235-244 https://doi.org/10.3348/kjr.2014.15.2.235
  29. Chang S, Kim SH, Lim HK, Kim SH, Lee WJ, Choi D, et al. Needle tract implantation after percutaneous interventional procedures in hepatocellular carcinomas: lessons learned from a 10-year experience. Korean J Radiol 2008;9:268-274 https://doi.org/10.3348/kjr.2008.9.3.268
  30. Livraghi T, Lazzaroni S, Meloni F, Solbiati L. Risk of tumour seeding after percutaneous radiofrequency ablation for hepatocellular carcinoma. Br J Surg 2005;92:856-858 https://doi.org/10.1002/bjs.4986
  31. Mulier S, Mulier P, Ni Y, Miao Y, Dupas B, Marchal G, et al. Complications of radiofrequency coagulation of liver tumours. Br J Surg 2002;89:1206-1222 https://doi.org/10.1046/j.1365-2168.2002.02168.x
  32. Tateishi R, Shiina S, Teratani T, Obi S, Sato S, Koike Y, et al. Percutaneous radiofrequency ablation for hepatocellular carcinoma. An analysis of 1000 cases. Cancer 2005;103:1201-1209 https://doi.org/10.1002/cncr.20892
  33. Jaskolka JD, Asch MR, Kachura JR, Ho CS, Ossip M, Wong F, et al. Needle tract seeding after radiofrequency ablation of hepatic tumors. J Vasc Interv Radiol 2005;16:485-491 https://doi.org/10.1097/01.RVI.0000151141.09597.5F
  34. Llovet JM, Vilana R, Bru C, Bianchi L, Salmeron JM, Boix L, et al.; Barcelona Clinic Liver Cancer (BCLC) Group. Increased risk of tumor seeding after percutaneous radiofrequency ablation for single hepatocellular carcinoma. Hepatology 2001;33:1124-1129 https://doi.org/10.1053/jhep.2001.24233
  35. Park SI, Kim IJ, Lee SJ, Shin MW, Shin WS, Chung YE, et al. Angled cool-tip electrode for radiofrequency ablation of small superficial subcapsular tumors in the liver: a feasibility study. Korean J Radiol 2016;17:742-749 https://doi.org/10.3348/kjr.2016.17.5.742
  36. Shirai K, Tamai H, Shingaki N, Mori Y, Moribata K, Enomoto S, et al. Clinical features and risk factors of extrahepatic seeding after percutaneous radiofrequency ablation for hepatocellular carcinoma. Hepatol Res 2011;41:738-745 https://doi.org/10.1111/j.1872-034X.2011.00841.x
  37. Poon RT, Ng KK, Lam CM, Ai V, Yuen J, Fan ST. Radiofrequency ablation for subcapsular hepatocellular carcinoma. Ann Surg Oncol 2004;11:281-289 https://doi.org/10.1245/ASO.2004.08.018
  38. Wu LW, Chen CY, Liu CJ, Chen MY, Liu PC, Liu PF, et al. Multipolar radiofrequency ablation with non-touch technique for hepatocellular carcinoma ${\leq}$ 3 cm: a preliminary report. Advances in Digestive Medicine 2014;1:80-85 https://doi.org/10.1016/j.aidm.2013.09.004
  39. Li Y, Xu KS, Li JS, Jia WD, Liu WB, He XD, et al. The research of no-touch isolation technique on the prevention of postoperative recurrence and metastasis of hepatocellular carcinoma after hepatectomy. Hepatogastroenterology 2014;61:784-791
  40. Miyazono F, Takao S, Natsugoe S, Uchikura K, Kijima F, Aridome K, et al. Molecular detection of circulating cancer cells during surgery in patients with biliary-pancreatic cancer. Am J Surg 1999;177:475-479 https://doi.org/10.1016/S0002-9610(99)00086-0
  41. Hayashi N, Egami H, Kai M, Kurusu Y, Takano S, Ogawa M. Notouch isolation technique reduces intraoperative shedding of tumor cells into the portal vein during resection of colorectal cancer. Surgery 1999;125:369-374 https://doi.org/10.1016/S0039-6060(99)70003-6
  42. Liu CL, Fan ST, Cheung ST, Lo CM, Ng IO, Wong J. Anterior approach versus conventional approach right hepatic resection for large hepatocellular carcinoma: a prospective randomized controlled study. Ann Surg 2006;244:194-203 https://doi.org/10.1097/01.sla.0000225095.18754.45
  43. Livraghi T, Solbiati L, Meloni MF, Gazelle GS, Halpern EF, Goldberg SN. Treatment of focal liver tumors with percutaneous radio-frequency ablation: complications encountered in a multicenter study. Radiology 2003;226:441-451 https://doi.org/10.1148/radiol.2262012198

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  3. Recent technical advances in radiofrequency ablations for hepatocellular carcinoma vol.10, pp.4, 2018, https://doi.org/10.18528/ijgii210050