• Title/Summary/Keyword: Radiofrequency Ablation

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2018 심방세동 카테터 절제술 대한민국 진료지침: Part II

  • Yu, Hui-Tae;Jeong, Dong-Seop;Park, Hui-Nam;Park, Hyeong-Seop;Kim, Ju-Yeon;Kim, Jun;Lee, Jeong-Myeong;Kim, Gi-Hun;Yun, Nam-Sik;No, Seung-Yeong;O, Yong-Seok;Jo, Yeong-Jin;Shim, Jaemin
    • International Journal of Arrhythmia
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    • v.19 no.3
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    • pp.235-284
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    • 2018
  • In this part the writing group will cover strategies, techniques, and endpoints of atrial fibrillation (AF) ablation. Prior to all, electrical isolation of the pulmonary veins is recommended during all AF ablation procedures. In addition, techniques to be used for ablation of persistent and long-standing persistent AF, adjunctive ablation strategies, nonablative strategies to improve outcomes of AF ablation, and endpoints for ablation of paroxysmal, persistent, and long-standing persistent AF will be reviewed. Currently many technologies and tools are employed for AF ablation procedures. Radiofrequency energy, cryoablation, and other energy sources and tools are in various stages of development and/or clinical investigation. Finally, anticoagulation strategies pre-, during, and postcatheter ablation of AF and technical aspects of ablation to maximize safety are discussed in this section.

Radiofrequency Ablation in Treating Colorectal Cancer Patients with Liver Metastases

  • Xu, Chuan;Huang, Xin-En;Lv, Peng-Hua;Wang, Shu-Xiang;Sun, Ling;Wang, Fu-An
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8559-8561
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    • 2016
  • Purpose: To evaluate efficacy of radiofrequency ablation (RFA) in treating colorectal cancer patients with liver metastases. Methods: During January 2010 to April 2012, 56 colorectal cancer patients with liver metastases underwent RFA. CT scans were obtained one month after RFA for all patients to evaluate tumor response. (CR+PR+SD)/n was used to count the disease control rates (DCR). Survival data of 1, 2 and 3 years were obtained from follow up. Results: Patients were followed for 10 to 40 months after RFA (mean time, $25{\pm}10months$). Median survival time was 27 months. The 1, 2, 3 year survival rate were 80.4%, 71.4%, 41%, 1 % respectively. 3-year survival time for patients with CR or PR after RFA was 68.8% and 4.3% respectively, the difference was statistically significant. The number of CR, PR, SD and PD in our study was 13, 23, 11 and 9 respectively. Conclusions: RFA could be an effective method for treating colorectal cancer patients with liver metastases, and prolong survival time, especially for metastatic lesions less than or equal to 3 cm. But this result should be confirmed by randomized controlled studies.

Clinical Application of Transcatheter Arterial Chemoembolization Combined with Synchronous C-arm Cone-Beam CT Guided Radiofrequency Ablation in treatment of Large Hepatocellular Carcinoma

  • Wang, Zhi-Jun;Wang, Mao-Qiang;Duan, Feng;Song, Peng;Liu, Feng-Yong;Wang, Yan;Yan, Jie-Yu;Li, Kai;Yuan, Kai
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.1649-1654
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    • 2013
  • Objective: This work aimed to evaluate the safety and clinical efficacy of transcatheter arterial chemoembolization (TACE) combined with c-arm cone-beam CT guided synchronous radiofrequency ablation (RFA) in treatment of large hepatocellular carcinoma (HCC). Methods: 21 patients with large HCC were studied from January 2010 to March 2012. TACE combined with synchronous C-arm cone-beam CT guided RFA were performed on a total of 25 lesions. Conventional imaging examination (CEUS, enhanced CT or MRI) and AFP detection were regularly conducted to evaluate the technical success rate of combined treatment, complications, treatment response, time without disease recurrence and survival rate. Results: The technical success rate of combined treatment was 100%, without any significant complication. After 1 month, there were 19 cases with complete response and 2 cases with partial response, with an complete response rate of 90.4% (19/21) and a clinical effective rate of 100% (21/21). The complete response rates of single nodular lesions (100%, 17/17) was significantly higher than that of multiple nodular lesions (50%, 2/4) (P<0. 05). During 2 to 28 months of follow-up, in 19 cases with complete response, the average time without disease recurrence was $10.8{\pm}6$ months. The total survival rates of 6, 12 and 18 months in 21 patients were 100%, respectively. Conclusion: TACE combined with synchronous C-arm CT guided RFA is safe and effective for treatment of large HCC. The treatment efficacy for single nodular lesion is better than that for multiple nodular lesions.

Percutaneous Radiofrequency Ablation Guided by Contrast-enhanced Ultrasound in Treatment of Metastatic Hepatocellular Carcinoma after Liver Transplantation

  • Dai, Xin;Zhao, Hong-Qiang;Liu, Run-Hao;Xu, Chang-Tao;Zheng, Fang;Yu, Li-Bao;Li, Wei-Min
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.3709-3712
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    • 2012
  • This study evaluated the advantages and applications of contrast-enhanced ultrasound (CEUS)-supported percutaneous radiofrequency ablation (RFA) in the treatment of metastatic hepatocellular carcinoma after liver transplantation, based on clinical details. CEUS-supported percutaneous RFA was adopted to treat 12 patients with hepatic metastatic carcinomas after liver transplantation. The diameters of the metastatic carcinomas varied from 1 cm to 5 cm, and the foci were discovered after 3 months to 12 months. Each focus was diagnosed and localised by CEUS for RFA once or twice. Curative effects were evaluated by CEUS or contrast-enhanced CT after the treatment. The re-examination results at 2 weeks post-treatment showed that the foci of 11 patients were ablated completely, whereas one patient with the largest focus required retreatment by RFA because of a partial residue. No local recurrence was found one month later in the re-examination. CEUS-supported percutaneous RFA in the treatment of hepatic metastatic carcinoma after liver transplantation has the advantages of accurate localisation, good efficacy, easy operation, and minimal invasion without any complications. Therefore, it can be recommended as the preferred therapy for hepatic metastatic carcinoma after liver transplantation.

Prognostic Value of Serum AFP, AFP-L3, and GP73 in Monitoring Short-term Treatment Response and Recurrence of Hepatocellular Carcinoma after Radiofrequency Ablation

  • Wang, Nan-Ya;Wang, Cong;Li, Wei;Wang, Guan-Jun;Cui, Guo-Zhen;He, Hua;Zhao, Heng-Jun
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.4
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    • pp.1539-1544
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    • 2014
  • Purpose: Alpha-fetoprotein (AFP), Lens culinaris agglutinin-reactive fraction of AFP (AFP-L3), and Golgi protein 73 (GP73) levels have been widely used as tumor markers for the diagnosis of hepatocellular carcinoma (HCC). The aim of this study was to investigate whether these tumor markers could be used to monitor short-term treatment response and recurrence of HCC in patients undergoing radiofrequency ablation (RFA). Methods: Between July 2012 and July 2013, 53 consecutive patients with newly diagnosed HCC were prospectively enrolled in this study. Among these, 32 patients underwent RFA, after which they were followed up prospectively at the First Hospital of Jilin University in China. Results: AFP, AFP-L3, and GP-73 values pre-RFA were not associated with tumor size, whereas AFP and GP-73 levels tended to be associated with tumor number, the presence of vascular invasion, deterioration of liver function, advanced-stage disease, and a poor performance status. GP-73 levels were dramatically elevated in the patients with hepatitis C-associated HCC. Neither pre-RFA nor 1-month post-RFA tumor marker values were associated with short-term outcome. The short-term recurrence rate of AFP-positive patients measured 1 month post-RFA was obviously higher than that of AFP-negative patients. Conclusions: AFP and GP-73 values were associated with clinical variables representing tumor growth and invasiveness, and the AFP value measured 1 month post-RFA was a strong predictor of short-term recurrence in patients with HCC.

Analysis of Radiofrequency Ablation of Small Renal Tumors in Patients at High Anesthetic and Surgical Risk: Urologist Experience with Follow-up Results in the Initial Six Months

  • Yuksel, Mehmet Bilgehan;Karakose, Ayhan;Gumus, Bilal;Tarhan, Serdar;Atesci, Yusuf Ziya;Akan, Zafer
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6637-6641
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    • 2013
  • Background: To evaluate the results of various types of radiofrequency ablation (RFA) treatment of renal tumors in patients with excessive anesthetic and surgical risk. Materials and Methods: Data for RFA performed in in high risk patients were retrospectively evaluated. Other RFA applications in patients with no anesthetic and/or surgical risk were excluded. RFA was by ultrasound or CT guided percutaneous (USG/CT-PRFA) and retroperitoneally or transperitoneally laparoscopic (R/T-LRFA) techniques under general or local anethesia. Follow-up data of enhanced CT or MRI after 1, 3 and 6 months were analysed for twelve RFA applications. Results: The RFA applications included 4 (40%) left-sided, 5 (50%) right-sided and 1 (10%) bilaterally RFA (simultaneously 1 right and 2 left). The localizations of tumors were 2 (16.6%) upper, 5 (41.6%) mid and 5 (41.6%) lower pole. The RFA applications included 9 (75%) USG-PRFA, 1 (8.3%) CT-PRFA, 1 (8.3%) T-LRFA and 1 (8.3%) R-LRFA. The mean age was $65.3{\pm}8.5$ (52-76) years. The mean tumor size was $29.6{\pm}6.08$ (15-40) mm. No complications related to the RFA were encountered in any of the cases. Failure (residual tumour) was determined in 8.3% (1/12) of USG-RFA application. The success rate was thus 91.7% (11/12). Other 1st, 3rd and 6th months follow-up data revealed no residua and recurrence. Conclusions: RFA application appears to be safe as a less invasive and effective treatment modality in selected cases of small renal tumors in individuals with excessive anesthetic and also surgical risk.

Efficacy of Transarterial Chemoembolization Combined with Radiofrequency Ablation in Treatment of Hepatocellular Carcinoma

  • Xu, Chuan;Lv, Peng-Hua;Huang, Xin-En;Wang, Shu-Xiang;Sun, Ling;Wang, Fu-An
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.6159-6162
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    • 2015
  • Purpose: To evaluate efficacy of transarterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) in treatment of patients with hepatocellular carcinoma. Materials and Methods: During January 2009 to March 2012, 80 patients with hepatocellular carcinoma underwent TACE, with or without RFA. Alfafetoprotein (AFP) was checked before and after procedure. CT scans were obtained one month after TACE or RFA for all patients to evaluate tumor changes. Complete response+partial response+stable disease (CR+PR+SD)/n were used to assess the disease control rate (DCR). Survival at 3, 6 and 12 months was compared in both groups. Results: AFP levels in TACE + RFA group dropped rapidly, becoming obviously lower than that of the TACE group. In the TACE + RFA group DCR was 93.8%, while only 76.8% in the TACE group. The treatment effect between the two groups was statistically significant (P<0.05) by Ridit analysis. 1 year survival rate in the TACE + RFA group was 92.5%, significantly higher than that of the TACE group at 77.5% (P<0.05). Conclusions: TACE and RFA as combined therapy method for patients with middle and terminal stage HCC gives full play to synergy between the two and improves the therapeutic effect.

Measurements of temperature distribution using an infrared optical fiber during radiofrequency ablation (적외선 투과 광섬유를 이용한 고주파 열치료 과정에서의 온도분포 측정)

  • Yoo, Wook-Jae;Seo, Jeong-Ki;Cho, Dong-Hyun;Jang, Kyoung-Won;Shin, Sang-Hun;Lee, Bong-Soo;Tack, Gye-Rae;Park, Byung-Gi;Moon, Joo-Hyun
    • Journal of Sensor Science and Technology
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    • v.17 no.6
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    • pp.397-405
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    • 2008
  • In this study, we have measured temperature distribution using infrared optical fibers during radiofrequency ablation (RFA). Infrared radiations generated from the water around inserted electrode are transferred by silver halide optical fibers and are measured by a thermopile sensor. Also, the output voltages of a thermopile sensor are compared with those of the thermocouple recorder. It is expected that a noncontact temperature sensor using an infrared optical fiber can be developed for the temperature monitoring during RFA treatments based on the results of this study.

Comparison of Combined Therapy Using Conventional Chemoembolization and Radiofrequency Ablation Versus Conventional Chemoembolization for Ultrasound-Invisible Early-Stage Hepatocellular Carcinoma (Barcelona Clinic Liver Cancer Stage 0 or A)

  • Lee, Hyukjoon;Yoon, Chang Jin;Seong, Nak Jong;Jeong, Sook-Hyang;Kim, Jin-Wook
    • Korean Journal of Radiology
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    • v.19 no.6
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    • pp.1130-1139
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    • 2018
  • Objective: To compare the therapeutic efficacy between conventional transarterial chemoembolization (cTACE) and combined therapy using cTACE and radiofrequency ablation (RFA) in ultrasound (US)-invisible early stage hepatocellular carcinoma (HCC). Materials and Methods: From January 2008 to June 2016, 167 patients with US-invisible early stage HCCs were treated with cTACE alone (cTACE group; n = 85) or cTACE followed by immediate fluoroscopy-guided RFA targeting intratumoral iodized oil retention (combined group; n = 82). Procedure-related complications, local tumor progression (LTP), time to progression (TTP), and overall survival (OS) were compared between the two groups. Multivariate analyses were performed to identify prognostic factors. Results: There was no major complication in either group. The cTACE group showed higher 1-, 3-, and 5-year LTP rates than the combined group; i.e., 12.5%, 31.7%, and 37.0%, respectively, in the cTACE group; compared to 7.3%, 16.5%, and 16.5%, respectively, in the combined group; p = 0.013. The median TTP was 18 months in the cTACE group and 24 months in the combined group (p = 0.037). Cumulative 1-, 3-, and 5-year OS rates were 100%, 93.2%, and 87.7%, respectively, in the cTACE group and 100%, 96.6%, and 87.4%, respectively, in the combined group (p = 0.686). Tumor diameter > 20 mm and cTACE monotherapy were independent risk factors for LTP and TTP. Conclusion: Combined therapy using cTACE followed by fluoroscopy-guided RFA is a safe and effective treatment in US-invisible early stage HCCs. It provides less LTP and longer TTP than cTACE alone.