Abstract
Radiofrequency ablation (RFA) has been clinically employed in Japan, and its usefulness in the treatment of hepatocellular carcinoma (HCC) has been reported by many researchers. In the present study, the convex puncture probe PVT-350BTP, rather than a conventional convex probe, was used for RFA for the treatment of HCC and its usefulness was assessed. At the same time, evaluation of the therapeutic effect using ultrasound contrast agent was investigated. The subjects were 20 patients (16 men and 4 women) with 20 HCC nodules as confirmed by contrast CT or abdominal angiography. No nodules were ≤1.0 cm in diameter, 12 were 1.1 cm - 2.0 cm, and 8 were 2.1 cm - 3.0 cm. An Aplio diagnostic ultrasound system (Toshiba Medical Systems, Tokyo, Japan) and the PVT-350BTP probe (Toshiba) were employed for RFA. The PVT-350BTP supports puncture angles of 55, 70, 85, and 100 degrees. By mounting various types of puncture adapters on the probe, 13 G to 22 G puncture needles can be used. The needle can easily be attached and detached by operating a lever. Contrast echo studies with Levovist were performed before and after RFA, and the results were evaluated using the Advanced Dynamic Flow (ADF) imaging technique. Puncture was performed successfully using this probe for 20 cases with 20 nodules. It was confirmed that RFA with the PVT-350BTP permits percutaneous treatment to be performed more reliably than with a conventional probe.
Highlights
Radiofrequency ablation (RFA)[1,2,3] has been clinically employed in Japan, and its usefulness in the treatment of hepatocellular carcinoma (HCC) has been reported by many researchers
The PVT-350BTP could have been used in this case if artificial pleural effusion had been employed [7], but we demonstrated in a previous study that the micro-convex probe permits RFA to be performed successfully without artificial pleural effusion for the treatment of HCC nodules in S8, and we decided to use the micro-convex probe in this case.[8]
In the contrast echo examinations performed before the RFA procedure in order to evaluate the therapeutic effect, blood flowing into the tumor or contrast enhancement of the tumor was observed in the early arterial phase in every case
Summary
Radiofrequency ablation (RFA)[1,2,3] has been clinically employed in Japan, and its usefulness in the treatment of hepatocellular carcinoma (HCC) has been reported by many researchers. RFA can be performed in various ways: percutaneously, laparoscopically, via a small incision, or intraoperatively. We generally perform echo-guided percutaneous RFA, and we are attempting RFA with 3D echo imaging.[4] In the present study, we employed a convex puncture probe, the PVT350BTP, rather than a conventional convex probe, for RFA for the treatment of HCC and assessed its usefulness. Evaluation of the therapeutic effect using ultrasound contrast agent was investigated
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