Computed tomography-guided radiofrequency ablation combined with transarterial embolization assisted by a three-dimensional visualization ablation planning system for hepatocellular carcinoma in challenging locations: a preliminary study

Huo J et al. Comparative Effectiveness of Computed Tomography-Versus Ultrasound-Guided Percutaneous Radiofrequency Ablation Among Medicare Patients 65 Years of Age or Older With Hepatocellular Carcinoma. Value Health 2019; 22(3):284–292 Die Inzidenz des Leberzellkarzinoms hat sich in den letzen 20 Jahren mehr als verdoppelt. 2018 wurden in den USA mehr als 31 600 neue Fälle registriert, knapp die Hälfte dieser Patienten war älter als 65 Jahre. Die damit verbundenen jährlichen Kosten werden auf 455 Millionen US Dollar geschätzt. Für fortgeschrittene, inoperable Fälle steht die Radiofrequenzablation als Therapieoption zur Verfügung, die Ultraschall- oder Computertomographie-gestützt durchgeführt werden kann. Die Autoren vergleichen die Effektivität beider Bildgebungstechniken für das Verfahren.

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Laparoscopic Repair of a Diaphragmatic Hernia Associated with Radiofrequency Ablation for Hepatocellular Carcinoma: Lessons from a Case and the Review of the Literature

International Surgery ◽

10.9738/intsurg-d-14-00025.1 ◽

2014 ◽

Vol 99 (4) ◽

pp. 384-390 ◽

Cited By ~ 3

Author(s):

Ryohei Nomura ◽

Hiromi Tokumura ◽

Makoto Furihata

Keyword(s):

Computed Tomography ◽

Hepatocellular Carcinoma ◽

Radiofrequency Ablation ◽

Diaphragmatic Hernia ◽

Laparoscopic Repair ◽

Laparoscopic Approach ◽

Review Of The Literature ◽

Gastrografin Enema ◽

History Of ◽

Segment Viii

Abstract We describe the case of a patient with a diaphragmatic hernia associated with radiofrequency ablation for hepatocellular carcinoma who was successfully treated by laparoscopic surgery. A 62-year-old man with a long history of hepatitis C-induced liver cirrhosis was admitted to our institution because of recurrent postprandial periumbilical pain. Eight years earlier, he had undergone radiofrequency ablation for hepatocellular carcinoma at hepatic segment VIII. Computed tomography, gastrografin enema examination revealed transverse colon obstruction because of a diaphragmatic hernia. We diagnosed diaphragmatic hernia associated with the prior radiofrequency ablation treatment. The patient underwent laparoscopic repair of the diaphragmatic hernia. Though the patient experienced the recurrence once, relaparoscopic treatment has improved the patient's conditions. Thus, diaphragmatic hernia can develop as a complication of radiofrequency ablation treatment. A laparoscopic approach is safe, feasible, and minimally invasive, even in patients with cirrhosis who develop iatrogenic diaphragmatic hernia as a complication of radiofrequency ablation treatment.

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Visualization of microvasculature and thrombi by X-ray phase-contrast computed tomography in hepatocellular carcinoma

Journal of Synchrotron Radiation ◽

10.1107/s1600577516001016 ◽

2016 ◽

Vol 23 (2) ◽

pp. 600-605 ◽

Cited By ~ 8

Author(s):

Jianbo Jian ◽

Hao Yang ◽

Xinyan Zhao ◽

Ruijiao Xuan ◽

Yujie Zhang ◽

...

Keyword(s):

Computed Tomography ◽

Hepatocellular Carcinoma ◽

Phase Contrast ◽

Soft Tissues ◽

Three Dimensional ◽

X Ray ◽

Density Distributions ◽

Fine Structures ◽

Tumor Growth And Metastasis ◽

Micrometer Scale

Visualization of the microvascular network and thrombi in the microvasculature is a key step to evaluating the development of tumor growth and metastasis, and influences treatment selection. X-ray phase-contrast computed tomography (PCCT) is a new imaging technique that can detect minute changes of density and reveal soft tissues discrimination at micrometer-scale resolution. In this study, six human resected hepatocellular carcinoma (HCC) tissues were investigated with PCCT. A histological stain was added to estimate the accuracy of PCCT. The results showed that the fine structures of the microvasculature (measuring 30–100 µm) and thrombi in tiny blood vessels were displayed clearly on imaging the HCC tissues by PCCT. Moreover, density distributions of the thrombi were obtained, which could be reliably used to distinguish malignant from benign thrombi in HCC. In conclusion, PCCT can clearly show the three-dimensional subtle structures of HCC that cannot be detected by conventional absorption-based computed tomography and provides a new method for the imageology of HCC.

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A Comparison between Three-Dimensional Visualization Guided Hepatectomy and Ultrasonography Guided Radiofrequency Ablation in the Treatment of Small Hepatocellular Carcinoma within the Milan Criteria

BioMed Research International ◽

10.1155/2016/8931732 ◽

2016 ◽

Vol 2016 ◽

pp. 1-10 ◽

Cited By ~ 1

Author(s):

Tian-pei Guan ◽

Chi-hua Fang ◽

Jian Yang ◽

Nan Xiang ◽

Qing-shan Chen ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Radiofrequency Ablation ◽

Cox Regression ◽

Alternative Therapy ◽

Three Dimensional ◽

Primary Treatment ◽

Small Hepatocellular Carcinoma ◽

Visualization System ◽

Tumor Number ◽

Serum Alpha Fetoprotein

Background. Treatment selection for small hepatocellular carcinoma (sHCC) is controversial. We aimed to compare the outcomes of medical imaging three-dimensional visualization system (MI-3DVS) guided surgical resection (SR) and ultrasonography guided radiofrequency ablation (RFA) for sHCC.Methods. In total, 194 patients who underwent SR or RFA in our hospital between January 2006 and May 2010 were retrospectively enrolled. Overall survival (OS), recurrence-free survival (RFS), and postoperative complications were compared. Cox regression was used to estimate the benefits of MI-3DVS-guided SR on OS and RFS.Results. Ninety-two patients underwent SR and 102 underwent RFA. The SR group experienced more complications (41.3% versus 19.6%) and longer hospital stay (18.04±7.11versus13.06±5.59) (bothp<0.05). The 1-, 2-, 3-, 4-, and 5-year OS was 96.7%, 95.7%, 93.5%, 83.5%, and 61.1% in the SR group and 95.0%, 88.1%, 72.7%, 56.9%, and 39.5% in the RFA group. Corresponding RFS was 95.7%, 94.6%, 84.7%, 59.8%, and 40.2% in SR group and 91.2%, 80.3%, 60.5%, 32.3%, and 22.3% in RFA group. The 5-year OS and RFS were higher in SR group (bothp<0.001). Interestingly, there was no significance in OS and RFS among subgroups aged >60 years. Independent predictors of OS and RFS, respectively, were intervention (HR, 2.769 and 1.933), tumor number (HR, 5.128 and 3.903), and serum alpha-fetoprotein (AFP) (HR, 1.871 and 1.474) (allp<0.05).Conclusions. MI-3DVS based hepatectomy should be considered primary treatment while RFA can be treated as alternative therapy for older patients. Intervention, tumor number, and AFP are independent predictors for both survival and recurrence.

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Combination of radiofrequency ablation and transcatheter arterial chemoembolization to treat hepatocellular carcinoma: measurement of distance from needle tip to nodule for assessment of local tumor progression

Journal of International Medical Research ◽

10.1177/0300060519844667 ◽

2019 ◽

Vol 47 (6) ◽

pp. 2516-2523 ◽

Cited By ~ 1

Author(s):

Wang Haochen ◽

Wang Jian ◽

Song Li ◽

Lv Tianshi ◽

Tong Xiaoqiang ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Prognostic Factors ◽

Radiofrequency Ablation ◽

Tumor Progression ◽

Minimum Distance ◽

Transcatheter Arterial Chemoembolization ◽

Three Dimensional ◽

Local Tumor Progression ◽

Local Tumor ◽

Arterial Chemoembolization

Objective This study was performed to determine the relationship between the minimum distance from the radiofrequency ablation (RFA) needle tip to the tumor and local tumor progression (LTP) of hepatocellular carcinoma (HCC) nodules and identify prognostic factors for LTP. Methods We reviewed 197 patients (197 nodules) who underwent RFA after transcatheter arterial chemoembolization for HCC from January 2010 to January 2015. Three-dimensional registration of images was used to calculate the minimum distance from the tip to the tumor. We then divided the minimum distance into two groups: <2 and ≥2 mm. Contrast-enhanced computed tomography was performed after treatment. The LTP rate was calculated 1 and 3 years after RFA. We performed multivariate analysis to identify independent prognostic factors for LTP. Results The cumulative 1-year LTP rates in the <2- and ≥2-mm groups were 82.7% and 4.3%, respectively, and the cumulative 3-year LTP rates in the two groups were 94.8% and 10.8%, respectively. The minimum distance from the needle tip to the tumor was an independent prognostic factor for LTP. Conclusions A minimum distance of 2 mm from the needle tip to the tumor should be completely ablated along with the tumor.

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