- 주저자 : Kim JE, Kim YS, Rhim H, Lim HK, Lee MW, Choi D, Shin SW, Cho SK
- 영문 제목 : Outcomes of patients with hepatocellular carcinoma referred for percutaneous radiofrequency ablation at a tertiary center: Analysis focused on the infeasibility with the use of ultrasonography guidance
- 한글 제목 : 간세포암의 고주파열치료술을 위해 3차의료기관으로 의뢰된 환자의 결과분석: 초음파유도 시술이 어려운 경우에 대한 분석
- 저널 : Eur J Radiol
- 연도 : 2011
- 권 / 쪽 : 79 / 80-84
- 초록
PURPOSE:
This study aimed to assess the feasibility of performing ultrasonography (US)-guided percutaneous radiofrequency (RF) ablation on patients with hepatocellular carcinoma (HCC) and identify causes of procedure infeasibility and its predisposing conditions.
MATERIALS AND METHODS:
A total of 109 consecutive patients (male:female=86:23; mean 59.9 years) with 136 HCCs (mean 1.8 cm) who had been referred for planning US were analyzed. We evaluated overall procedure feasibility as well as specific factors relating to feasibility, including inability to visualize the tumor with US and factors relating to safety of the procedure.
RESULTS:
The use of percutaneous RF ablation was concluded as infeasible for 45 tumors (33.1%). Reasons for infeasibility included tumor invisibility (n=32), a high risk of collateral thermal injury (n=5), absence of a safe electrode path (n=5) and a combination of factors (n=3). Among 136 tumors, 36(26.5%) were invisible due to isoechogenicity (n=16), indiscrimination from surrounding cirrhotic nodules (n=10) or an unfavorable location (n=10). Tumor invisibility was significantly attributed to a small tumor size (P<0.001, risk ratio=0.823) and the presence of macronodular cirrhosis (P=0.006, risk ratio=4.117). Seven patients with invisible tumors were treated with RF ablation after follow-up (n=4) or with use of adjacent structures as landmarks (n=3). Ultimately, 65 of 109 patients were treated with percutaneous RF ablation.
CONCLUSIONS:
US-guided percutaneous RF ablation for HCC was feasible in about two-thirds of candidates. Infeasibility was mostly due to inability to visualize the tumor with US, especially for patients with smaller tumor and macronodular cirrhosis."
