Purpose. To compare the efficacies of radiofrequency thermal ablation (RFTA) of small hepatocellular carcinomas (HCC) using a single cool-tip needle electrode or a 9-pronged hooked electrode. Methods. 83 HCC nodules ≤ 3 cm underwent RFTA, 37 with a single exposed-tip needle electrode and continuous saline cooling (CT30 Group) and the other 46 with a nine-array Starburst XL hooked electrode (SB9 Group). Lesion necrosis was assessed with spiral computed tomography (CT) 45 days after the procedure, and RFTA was repeated if viable residual tumor tissue was observed. In lesions displaying complete necrosis (i.e., absence of vascularization) after 1-2 RFTA sessions, CT studies were repeated 12 months later to evaluate local recurrence. Results. 81/83 (97.6%) lesions presented CT evidence of complete necrosis approximately 45 days after one (74 nodules) or two (seven nodules) RFTA sessions: immediate success rates were slightly but not significantly higher in the SB9 group (100% vs. 94.6% of CT30-treated lesions). To date, 51 of these 81 nodules (23 treated with CT30, 28 with SB9 electrodes) have been subjected to a 12- month follow-up CT, which revealed local recurrence at the site of 9/51 (17.6%) nodules (mean dia- meter: 2.37 ± 0.55 cm). The recurrence rate among the 23 CT30-treated lesions (5 recurrences, 21.7%) was higher than that observed among the 28 SB9-ablated nodules (4 recurrences, 14.3%), but this difference was not statistically significant (P=0.7). Conclusions. Immediate success rates, defined as complete lesion necrosis on post-procedural CT, are high (> 95%) with both RFTA techniques. One year after apparently successful ablation, local recurrence can be detected in around 20% of all cases, but this outcome shows no significant corre- lation with the RFTA technique used.
Trattamento con Radiofrequenza del carcinoma epatocellulare: dati preliminari di comparazione tra “ago freddo” versus “ago ad uncini” nelle lesioni fino a 3 cm
VELTRI, Andrea;RIZZETTO, Mario
2004-01-01
Abstract
Purpose. To compare the efficacies of radiofrequency thermal ablation (RFTA) of small hepatocellular carcinomas (HCC) using a single cool-tip needle electrode or a 9-pronged hooked electrode. Methods. 83 HCC nodules ≤ 3 cm underwent RFTA, 37 with a single exposed-tip needle electrode and continuous saline cooling (CT30 Group) and the other 46 with a nine-array Starburst XL hooked electrode (SB9 Group). Lesion necrosis was assessed with spiral computed tomography (CT) 45 days after the procedure, and RFTA was repeated if viable residual tumor tissue was observed. In lesions displaying complete necrosis (i.e., absence of vascularization) after 1-2 RFTA sessions, CT studies were repeated 12 months later to evaluate local recurrence. Results. 81/83 (97.6%) lesions presented CT evidence of complete necrosis approximately 45 days after one (74 nodules) or two (seven nodules) RFTA sessions: immediate success rates were slightly but not significantly higher in the SB9 group (100% vs. 94.6% of CT30-treated lesions). To date, 51 of these 81 nodules (23 treated with CT30, 28 with SB9 electrodes) have been subjected to a 12- month follow-up CT, which revealed local recurrence at the site of 9/51 (17.6%) nodules (mean dia- meter: 2.37 ± 0.55 cm). The recurrence rate among the 23 CT30-treated lesions (5 recurrences, 21.7%) was higher than that observed among the 28 SB9-ablated nodules (4 recurrences, 14.3%), but this difference was not statistically significant (P=0.7). Conclusions. Immediate success rates, defined as complete lesion necrosis on post-procedural CT, are high (> 95%) with both RFTA techniques. One year after apparently successful ablation, local recurrence can be detected in around 20% of all cases, but this outcome shows no significant corre- lation with the RFTA technique used.
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