Radiofrequency Ablation For Liver Cancer Research Articles

An in silico assessment on the potential of using saline infusion to overcome non-confluent coagulation zone during two-probe, no-touch bipolar radiofrequency ablation of liver cancer.

No-touch bipolar radiofrequency ablation (bRFA) is known to produce incomplete tumour ablation with a 'butterfly-shaped' coagulation zone when the interelectrode distance exceeds a certain threshold. Although non-confluent coagulation zone can be avoided by not implementing the no-touch mode, doing so exposes the patient to the risk of tumour track seeding. The present study investigates if prior infusion of saline into the tissue can overcome the issues of non-confluent or butterfly-shaped coagulation. A computational modelling approach based on the finite element method was carried out. A two-compartment model comprising the tumour that is surrounded by healthy liver tissue was developed. Three cases were considered; i) saline infusion into the tumour centre; ii) one-sided saline infusion outside the tumour; and iii) two-sided saline infusion outside the tumour. For each case, three different saline volumes were considered, i.e. 6, 14 and 22 ml. Saline concentration was set to 15% w/v. Numerical results showed that saline infusion into the tumour centre can overcome the butterfly-shaped coagulation only if the infusion volume is sufficient. On the other hand, one-sided infusion outside the tumour did not overcome this. Two-sided infusion outside the tumour produced confluent coagulation zone with the largest volume. Results obtained from the present study suggest that saline infusion, when carried out correctly, can be used to effectively eradicate liver cancer. This presents a practical solution to address non-confluent coagulation zone typical of that during two-probe bRFA treatment.

Interventional Oncolytic Immunotherapy with LTX-315 for Residual Tumor after Incomplete Radiofrequency Ablation of Liver Cancer.

Objective: To investigate the feasibility of interventional oncolytic immunotherapy with LTX-315 for residual tumors after incomplete radiofrequency ablation (iRFA) of VX2 liver tumors in a rabbit model. Methods: For in vitro experiments, VX2 tumor cells were treated with: (1) phosphate buffered saline, (2) radiofrequency hyperthermia (RFH), (3) LTX-315, and (4) RFH plus LTX-315. The residual tumors after iRFA of VX2 liver tumors were treated with: (1) phosphate buffered saline served as control, (2) 2 mg LTX-315, and (3) 4 mg LTX-315. MTS assay, fluorescence microscopy, and flow cytometry were used to compare cell viabilities and apoptosis among different groups. Ultrasound imaging was used to follow up the tumor growth, which were correlated with the optical imaging and subsequent histology. Results: For in vitro experiments, compared with the other three groups, MTS assay demonstrated the lowest cell viability, fluorescence microscopy showed the least survival cells, and apoptosis analysis revealed the highest percentage of apoptosis cells in the combination treatment groups (p < 0.001). For in vivo experiments, ultrasound imaging showed the smallest tumor volume in the group with 4 mg LTX-315 therapy compared with the other two groups (p < 0.001). The optical imaging and histopathological analysis showed complete necrosis of the tumors in the group with 4 mg LTX-315 therapy. A significant increase of CD8+ T cells and HSP70 and a significant decrease of Tregs were observed in residual tumors in the group with 2 mg LTX-315 therapy compared with the control group (p < 0.001). Conclusion: Interventional oncolytic immunotherapy with LTX-315 for residual tumors after iRFA of liver cancer is feasible, which may open up new avenues to prevent residual tumors after RFA of intermediate-to-large liver cancers.

Multi-stage puncture path planning algorithm of ablation needles for percutaneous radiofrequency ablation of liver tumors

This paper designs a multi-stage puncture path planning algorithm of ablation needles for percutaneous radiofrequency ablation of liver tumors, in order to guide or assist clinicians automatically plan the puncture path of ablation needle, and improve the safety and effectiveness of percutaneous radiofrequency ablation for liver cancer. Firstly, the initial feasible puncture paths satisfying the hard constraints are obtained by quantifying different clinical multi-constraint conditions. Then, according to the soft constraints, the risk index of puncture path is designed to realize the first-stage path planning. Secondly, considering the zero potential energy point and multi-tumor puncture, we embed the gravitational additional potential field to improve the traditional artificial potential field, and the second-stage path planning of candidate puncture paths is carried out by calculating the comprehensive potential energy of the paths. Finally, the reliability of the ablation needle trajectory is evaluated based on the relationship between the candidate puncture paths and liver segments, and the third-stage path planning is realized to determine the optimal puncture path. Through the quantitative and qualitative evaluation of the results, it is proved that our algorithm can obtain an optimal puncture path that meets the clinical conditions, which is expected to guide clinicians in the puncture path planning of percutaneous radiofrequency ablation for liver cancer.

Quantification of Liver Fat Content after Radiofrequency Ablation for Liver Cancer: Correlation with Hepatic Perfusion Disorders.

Purpose: To quantitatively investigate the correlation between liver fat content and hepatic perfusion disorders (HPD) after radiofrequency ablation (RFA) for liver cancer using magnetic resonance imaging (MRI)-determined proton density fat fraction (PDFF). Materials and methods: A total of 150 liver cancer patients underwent liver MRI examination within one month after RFA and at four months after RFA. According to the liver fat content, they were divided into non-, mild, moderate, and severe fatty liver groups. The liver fat content and hepatic perfusion disorders were determined using PDFF images and dynamic contrast-enhanced MRI images. The relationship between the liver fat content and HPD was investigated. Results: At the first postoperative MRI examination, the proportion of patients in the nonfatty liver group with hyperperfused foci (11.11%) was significantly lower than that in the mild (30.00%), moderate (42.86%), and severe fatty liver (56.67%) groups (p < 0.05), whereas the proportions of patients with hypoperfused foci (6.67%, 7.5%, 5.71%, and 6.67%, respectively) were not significantly different among the four groups (p > 0.05). In the nonfatty liver group, the liver fat content was not correlated with hyperperfusion abnormalities or hypoperfusion abnormalities. By contrast, in the three fatty liver groups, the liver fat content was correlated with hyperperfusion abnormalities but was not correlated with hypoperfusion abnormalities. At the second postoperative MRI examination, six patients in the nonfatty liver group were diagnosed with fatty liver, including two patients with newly developed hyperperfusion abnormalities and one patient whose hypoperfusion abnormality remained the same as it was in the first postoperative MRI examination. Conclusion: There was a high correlation between the liver fat content and hyperperfusion abnormalities after RFA for liver cancer. The higher the liver fat content was, the higher the was risk of hyperperfusion abnormalities. However, there was little correlation between liver fat content and hypoperfusion abnormalities, and the increase in postoperative liver fat content did not induce or alter the presence of hypoperfused foci.

Value of 18F-FDG PET/MR Imaging in the Early Evaluation of Treatment Response following Radiofrequency Ablation of Liver Cancer in a Rabbit Model

PurposeTo test the hypothesis that 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) and magnetic resonance (MR) imaging can detect early residual tumor following radiofrequency (RF) ablation of liver cancer using a VX2 tumor model. Materials and MethodsTwenty-four rabbits with VX2 liver tumors were randomly divided into 3 groups (n = 8/group): Group 1 without RF ablation treatment, Group 2 with complete ablation, and Group 3 with partial ablation. An 18F-FDG PET/MR imaging scan was obtained within 2 hours after RF ablation. The maximum standardized uptake values (SUV) of the nontreated liver tumor, benign periablational enhancement (BPE), residual tumor, ablated tumor, and adjacent liver parenchyma and mean SUV of the normal liver were measured. The ratios of maximum SUV for these targets to the mean SUV of the normal liver (TNR) were calculated and compared. ResultsThe mean TNR of the nontreated liver tumors in Group 1 was significantly greater than that of the adjacent liver parenchyma (8.68 ± 0.71 vs 1.89 ± 0.26, P < .001). In Group 2, the mean TNR of BPE was significantly greater than that of the adjacent liver parenchyma (2.85 ± 0.20 vs 1.86 ± 0.25, P < .001). In Group 3, the mean TNR of the residual tumor was significantly greater than that of BPE (8.64 ± 0.59 vs 2.78 ± 0.23, P < .001), which was significantly greater than that of completely ablated tumor (2.78 ± 0.23 vs 0.50 ± 0.06, P < .001). Conclusions18F-FDG PET/MR imaging may serve as a promising imaging tool for the early detection of viable residual tumors due to incomplete tumor ablation.

Comparison of Effects of Radiofrequency Ablation of Liver Cancer Guided by CT Images Based on Deep Learning Algorithm

Objective. To investigate the paper radiofrequency ablation (RFA) CT-guided feasibility of hepatocellular carcinoma (primary liver cancer) treatment, safety, and clinical efficacy of the use of deep learning algorithms. Method. A total of 47 cases of primary liver cancer patients were included: 21 cases of CT-guided liver lesions in line with RFA (C-CT group) and, in the same period, 26 cases of spiral CT-guided liver lesions in line with RFA (S-CT group). Two groups of patients were recorded immediately after the total operation time and ablation time, the acceptable radiation dose was observed in the incidence of postoperative complications of 7d, and the postoperative hospital stay was recorded to evaluate the efficacy of the treatment of lesions in 1, 3, and 6 months after RFA. Results. All 47 patients were successful; two technical success rates were 100%. There was a significant difference ( P &lt; 0.05) in the total operation time groups, ablation time, and acceptable radiation dose. And there was no significant difference ( P &lt; 0.05) in postoperative complications of 7d groups, postoperative hospital stay, and local disease control. There was a significant difference ( P &lt; 0.05) in the S-CT group, seven ablation residual or recurrent lesions during the follow-up ratio of 26.9%, and C-CT groups compared with only 14.3%. Conclusion. CT-guided RFA treatment of primary liver cancer patients is safe, effective, and superior to the conventional spiral CT-guided ablation lesion site-specific terms.

Artificial Ascites in Radiofrequency Ablation for Liver Cancer

Background: Radio Frequency Ablation (RFA) is one of the treatment modality for liver tumor either as primary tumor as well as secondary malignancy. Occasionally, a good ablation can’t be performed due to the tumor location. To assists the ablation in this particular case, some fluid can be deposited inside the abdomen which is called as artificial ascites. The aim of this study is to report and evaluate the method of artificial ascites in RFAMethod: This was a case series study consist of 19 consecutive patients that had been treated with ultrasound-guided RFA using artificial ascites from 2014 to 2017.Result: Artificial ascites was successfully performed in all 19 patients (100%) with total of 53 hepatocellular carcinoma (HCC) lesions in 34 RFA’s sessions and tumor size ranges from 10mm to 50mm. Most of the tumors were primary tumor (14/19). 9 patients had single tumor and 10 patients had multiple tumors and most of the tumor were located in segment 5 (14/53). Artificial ascites was performed using 5% dextrose in water (D/W)solution ranging from 500ml to 1500ml. No adverse effect occurred during and after the procedure.Conclusion: Percutaneous RFA using artificial ascites technique was safe and effective fortreating HCC

The effects of electrical and thermal boundary condition on the simulation of radiofrequency ablation of liver cancer for tumours located near to the liver boundary

Effects of different boundary conditions prescribed across the boundaries of radiofrequency ablation (RFA) models of liver cancer are investigated for the case where the tumour is at the liver boundary. Ground and Robin-type conditions (electrical field) and body temperature and thermal insulation (thermal field) conditions are examined. 3D models of the human liver based on publicly-available CT images of the liver are developed. An artificial tumour is placed inside the liver at the boundary. Simulations are carried out using the finite element method. The numerical results indicated that different electrical and thermal boundary conditions led to different predictions of the electrical potential, temperature and thermal coagulation distributions. Ground and body temperature conditions presented an unnatural physical conditions around the ablation site, which results in more intense Joule heating and excessive heat loss from the tissue. This led to thermal damage volumes that are smaller than the cases when the Robin type or the thermal insulation conditions are prescribed. The present study suggests that RFA simulations in the future must take into consideration the choice of the type of electrical and thermal boundary conditions to be prescribed in the case where the tumour is located near to the liver boundary.

The occurrence and clinical significance of contrast agent spillover on immediate enhanced CT reexamination after radiofrequency ablation of liver cancer

Objective: To investigate the relationship between radiofrequency ablation immediately after enhanced CT scanning and the occurrence of contrast agent spillover and postoperative severe bleeding, and analyze the risk factors for hepatocellular carcinoma (HCC). Methods: A retrospective analysis of 199 patients with hepatocellular carcinoma who underwent radiofrequency ablation of liver cancer in our hospital from January 2016 to January 2017 was reviewed. A total of 232 cases were treated with ablation. The agent spillovers were divided into two groups, one for the contrast agent spill group and the other for the non-contrast agent spill group. Its basic clinical data, laboratory data related to the risk of bleeding, and imaging data were analyzed to explore their clinical treatment effects and the risk factors for their occurrence. According to different data, t-test, χ2 test or logistic regression test was used for statistical analysis. Results: In 199 patients, a total of 232 cases were treated with ablation, including 138 males and 61 females. The average age was (57.56 ± 12.09) years and the average diameter of lesions was (3.42 ± 2.30) cm. A total of 30 cases (12.93%) of contrast agent spillover occurred immediately after the ablation of CT scanning needle. There were no severe bleeding and no special clinical intervention after the operation. The other 202 cases were non- contrast agent spill group, but 2 cases had severe bleeding and had corresponding clinical interventions. Univariate analysis showed that there were statistically significant differences in thoracentesis (P = 0.019), complications of cirrhosis (P < 0.001), and histological types of liver cancer (P = 0.013), and other clinical data [age, lesion size]. There were no significant differences in Child-Pugh classification, preoperative hemoglobin (HGB), platelet count, prothrombin time, APTT, international standardized ratio, number of puncture needles, and puncture length. There was also no significant difference in postoperative HGB (P = 0.160), preoperative-postoperative HGB change (P = 0.999), and length of hospital stay (P = 0.730) between the two groups. Logistic regression analysis showed that with cirrhosis (OR = 5.59, P < 0.001), transthoracic puncture (OR = 2.67, P = 0.021) may be a risk factor for contrast agent spillover after CT-enhanced CT scan in patients with hepatocellular carcinoma. Conclusion: Contrast agent spillover is not uncommon in the evaluation of curative effect of CT immediately after ablation (12.93%). It is not predictive for the occurrence of postoperative severe bleeding and does not require excessive clinical intervention. Liver cirrhosis and transthoracic cavity puncture may be the risk factors for its occurrence. The risk of severe postoperative bleeding should not be ignored for patients who have no contrast agent spills after surgery.

Artificial ascites-assisted ultrasound guided percutaneous radiofrequency ablation of liver tumors adjacent to the gastrointestinal tract

Objective To study the safety and efficacy of artificial ascites-assisted ultrasound guided percutaneous radiofrequency ablation (RFA) of liver tumors adjacent to the gastrointestinal tract. Methods After ultrasound-guided percutaneous placement of a central venous tube, saline was injected into the abdominal cavity. The presence of fluid between the liver tumor and its adjacent gastrointestinal organs forms a zone of isolation. Radiofrequency ablation (RFA) was then carried out. This is a retrospective study on 32 patients whose lesions were adjacent to the gastrointestinal tract treated from January 2015 to December 2016 with RFA after establishment of artificial ascites. One month after ablation, CT/MR was performed to evaluate whether the lesions were completely ablated. Results All the 39 lesions in the 32 patients were successfully treated with RFA after establishment of artificial ascites. The complete ablation rate was 92.3% (30/32) after one ablation session. One patient developed a high fever after surgery, another patient had nausea and vomiting during surgery, and two more patients complained of right shoulder and back pain. There were no severe complications such as hemorrhage or gastrointestinal perforation. There was no treatment related deaths. Conclusions For liver tumors which were adjacent to the gastrointestinal tract, establishment of artificial ascites significantly improved the visual field under ultrasound, and reduced the chance of collateral gastrointestinal thermal injury. The treatment of ascites-assisted ultrasound guided percutaneous radiofrequency ablation of liver cancer was safe and efficacious. Key words: Hepatocellular carcinoma; Radiofrequency ablation; Artificial ascites; Ultrasonography

Science to Practice: Molecular-targeted Drug Delivery in Combination with Radiofrequency Ablation of Liver Cancer: A Magic Bullet?

In an effort to improve the technical success rates and clinical outcomes of radiofrequency (RF) ablation, Yan et al validated the use of a tumor-penetrating peptide and thermosensitive doxorubicin (DOX)-loaded nanoparticles in combination with RF ablation in a hepatocellular carcinoma mouse model. By achieving higher chemotherapeutic drug concentrations in target lesions, fewer toxic effects, and improved survival end points in an animal tumor model, the authors conclude that superior tumor treatment with RF ablation is possible when combined with molecular-targeted drug delivery systems.

原发性肝癌射频消融术后胸腔积液的研究

目的：探讨原发性肝癌射频消融术后胸腔积液形成的影响因素，从而更好的评估射频消融的安全性。方法：对45例采用一次性完全射频消融治疗的肝癌患者进行回顾性分析，根据肿瘤位置不同分为(靠近膈肌组，≤10 mm)A组和(远离膈肌组，>10 mm)B组，观察是否出现胸腔积液并进行统计学分析，从而判定肿瘤位置是否是影响射频消融术后胸腔积液出现与否的因素。结果：A组和B组射频术后胸腔积液的发生率有显著差异。结论：肿瘤位置是影响肝癌射频消融术后是否出现胸腔积液的重要因素。 Objective: To investigate the factors influencing the formation of pleural effusion in patients with primary liver cancer after radiofrequency ablation, and to evaluate the safety of RFA. Methods: We retrospectively reviewed 45 primary hepatic carcinoma patients who accepted one-off complete radiofrequency ablation (RFA). According to the tumor location, they were divided into group A (close to the diaphragm, less than 10 mm) and group B (away from the diaphragm, more than 10 mm). Then we observed whether pleural effusion occurred or not in each case. The outcomes were analyzed statistically to determine whether the location of the tumor affects the occurrence of pleural effusion after RFA or not. Results: There was a significant difference in the incidence of pleural effusion between group A and group B. Conclusion: The location of tumor is an important factor that affects the occurrence of pleural effusion after RFA for liver cancer.

Ablation effects of noninvasive radiofrequency field-induced hyperthermia on liver cancer cells

To have in-depth analysis of clinical ablation effect of noninvasive radiofrequency field-induced hyperthermia on liver cancer cells, this paper collected liver cancer patients’ treatment information from 10 hospitals during January 2010 and December 2011, from which 1050 cases of patients were randomly selected as study object of observation group who underwent noninvasive radiofrequency field-induced hyperthermia treatment; in addition, 500 cases of liver cancer patients were randomly selected as study object of control group who underwent clinical surgical treatment. After treatment was completed, three years of return visit were done, survival rates of the two groups of patients after 1year, 2years, and 3years were compared, and clinical effects of radiofrequency ablation of liver cancer were evaluated. Zoom results show that the two groups are similar in terms of survival rate, and the difference is without statistical significance. 125 patients in observation group had varying degrees of adverse reactions, while 253 patients in control group had adverse reactions. There was difference between groups P<0.05, with significant statistical significance. It can be concluded that radiofrequency ablation of liver cancer is more secure. Therefore, the results of this study fully demonstrate that liver cancer treatment with noninvasive radiofrequency field-induced hyperthermia is with safety effect and satisfactory survival rate, thus with relatively high clinical value in clinical practice.

肝癌射频消融过程中热效应的研究现状

在肝癌的治疗上，射频消融的疗效逐渐得到肯定。理解射频消融过程中的热效应是实现肿瘤消融的基础。本文从热沉降效应、热灌溉效应、热传导效应、热烤箱效应四个方面，就肝癌射频消融过程的热效应的研究现状作如下综述。 The efficacy of radiofrequency ablation (RFA) has gradually been recognized in the treatment of liver cancer. Understanding the thermal effects of radiofrequency ablation is the basis of tumor ablation. In this paper, the research status of thermal effect of radiofrequency ablation of liver cancer will be introduced as follows: Heat sink effect, heat irrigate effect, heat conduct effect as well as heat oven effect.

Post-operative pericardial effusion following treatment of small hepatocellular carcinoma with radiofrequency ablation: A case report

Radiofrequency ablation (RFA) is a minimally invasive technique used to treat liver tumors. The current study presents the case of a patient with hepatocellular carcinoma who suffered from post-operative pericardial effusion following RFA treatment. We hypothesize that RFA thermal conduction may damage the diaphragm and pericardium, leading to local edema in the pericardium. RFA is a minimally invasive technique, however, adequate preparatory work must be performed prior to surgery, including a comprehensive assessment of the patient. During surgery, the location and extent of the region to receive RFA must be determined precisely in order to reduce the range of damage and to avoid post-operative complications. This study describes a case of pericardial effusion caused by RFA of liver cancer. We analyzed the causes and preventive measures for pericardial effusion in order to contribute to the prevention pericardial effusion that is complicated by RFA of liver cancer.

Some important issues in the translational medical research of radiofrequency ablation of liver cancer

With increasing use of radiofrequency (RF) ablation in the treatment of liver cancer,more clinical problems are encountered.Translational research is urgently needed to solve these problems which include:(1) RF needle functional characteristics; (2) effects of RF ablation on liver cancer related changes in pathology; (3) changes in invasive ness and metastatic potential of residual liver cancer cells after incomplete ablation,and their mechanisms; (4) changes in tumor-associated endothelial cell function in residual liver cancer tissues after incomplete ablation,and their mechanisms; (5) prevention and treatment of residual liver cancer after RF ablation; (6) changes in the host's antitumor immunity after RF ablation of liver cancer. Key words: Liver cancer; Radiofrequency ablation; Translational medicine

Ultrasound-guided assistant infusion technique for percutaneous radiofrequency ablation of liver cancer

To assess the value of an infusion-based separation technique to assist in ultrasound (US)-guided percutaneous radiofrequency ablation (RFA) of liver cancers abutting the liver edge. Twenty-four cases of malignant liver tumors abutting the hepatic edge were treated with US-guided puncture accompanied by the assistant infusion technique. The US-guided puncture was made with a 22-G needle through the hepatic tissue and into the abdominal cavity near the target tumor. Infusion of a saline solution was used to separate the liver from any surrounding structures so that percutaneous RFA could be safely performed. Complications, including gastrointestinal injury, hemorrhage and death, were recorded. Technical efficacy and safety were evaluated. Among the 24 patients, the target tumors were adjacent to the right kidney (n=6), colon (n=6), stomach (n=5), pericardium (n=4), and gall bladder (n=3). Twenty-three patients received a successful radical percutaneous RFA with assistant infusion. The assistant infusion volumes ranged from 80-390 ml and created spaces ranging from 0.8-2.5 cm between the liver and surrounding structures. Five of the cases with tumors adjacent to the stomach or colon received the largest volume infusions. The infusion failed to create a separation space in only one case, due to the presence of an adhesion; as a result, this patient was treated with palliative RFA. The mean hospital stay for all 24 patients was four days after surgery. No severe complications or deaths occurred. At 1-month follow-up, computed tomography images showed that 22 cases had complete ablation, yielding a technical success rate of 95.7% (22/23). No needle track implantation was observed. Assistant infusion for percutaneous radiofrequency ablation creates a protective space between the liver and surrounding structures in patients with liver tumors abutting the liver edge. This safe and effective assistant technique broadens the range of patients available for percutaneous RFA treatment.

Effects of general anesthesia on inflammatory response in patients after radiofrequency ablation for liver cancer

目的 评价全身麻醉对肝癌患者射频消融术后炎性反应的影响.方法 择期行射频消融术的原发性肝癌患者40例,年龄40～64岁,体重50～75 kg,性别不限,ASA分级Ⅱ或Ⅲ级,肝功能Child-Pugh分级A级.采用随机数字表法,将患者随机分为2组(n=20):局部麻醉组(L组)和全身麻醉组(G组).G组麻醉诱导:静脉注射异丙酚1～2 mg/kg和芬太尼2～4 μg/kg,插入喉罩后行机械通气.麻醉维持:吸入2％七氟醚,靶控输注瑞芬太尼,血浆靶浓度4 μg/L.术中维持BIS值45 ～ 60.L组穿刺部位注射1％利多卡因进行局部浸润麻醉.于麻醉前、术后1、24和48 h时抽取上肢静脉血样5 ml,采用ELISA法检测血清IL-6、IL-10、IL-8和热休克蛋白70(HSP70)的浓度.结果 与L组比较,G组术后1、24和48 h时血清IL-6和IL-8的浓度降低,术后24和48 h时血清HSP70浓度降低(P＜0.05)；两组术后各时点血清IL-10浓度差异无统计学意义(P＞0.05).结论 全身麻醉可抑制肝癌患者射频消融术后HSP70和促炎因子的生成,从而减轻全身炎性反应。

Assessment of ablative margin by MRI with ferucarbotran in radiofrequency ablation for liver cancer: comparison with enhanced CT

Our aim was to determine whether ablated liver parenchyma surrounding a tumour can be assessed by MRI with ferucarbotran administered prior to radiofrequency ablation (RFA) compared with enhanced CT. 55 hepatocellular carcinomas (HCCs) in 42 patients and 5 metastatic liver cancers in 3 patients were treated by RFA after ferucarbotran administration. We then performed T(2)* weighted MRI after 1 week and enhanced CT after 1 month. T(2)* weighted MRI demonstrated the ablated parenchyma as a low-intensity rim around the high intensity of the ablated tumour in these cases. The assessment was allocated to one of three grades: margin (+), high-intensity area with continuous low-intensity rim; margin zero, high-intensity area with discontinuous low-intensity rim; and margin (-), high-intensity area extending beyond the low-intensity rim. Margin (+), margin zero and margin (-) were found in 17, 35 and 5 nodules, respectively. All 17 nodules with margin (+) and 13 of those with margin zero were assessed as having sufficient ablative margins on CT. The remaining 22 nodules with margin zero had insufficient margins on CT. The overall agreement between MRI and CT for the diagnosis of the ablative margin was moderate (κ = 0.507, p < 0.001). No local recurrence was found in 15 HCC nodules with margin (+), whereas local recurrence was found in 4 (11.8%) out of 34 HCC nodules with margin zero. Administration of ferucarbotran before RFA enables the ablative margin to be visualised as a low-intensity rim, and also enables the evaluation of the ablative margin to be made earlier and more easily than with enhanced CT.

Science to Practice: Will Randomized Prospective Clinical Trials Be Necessary for RF Ablation of Large Liver Tumors with Liposomal Doxorubicin?

HomeRadiologyVol. 255, No. 1 Next SCIENCE TO PRACTICEScience to Practice: Will Randomized Prospective Clinical Trials Be Necessary for RF Ablation of Large Liver Tumors with Liposomal Doxorubicin?Evan C. UngerEvan C. UngerEvan C. UngerPublished Online:Mar 10 2010https://doi.org/10.1148/radiol.092424MoreSectionsFull textPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In AbstractThe study by Solazzo et al, defining the mechanisms of cell stress and repair, provides a scientific backstop to help support the clinical use of liposomal doxorubicin at radiofrequency ablation.References1 Solazzo S, Ahmed M, Schor-Bardach Ret al.. Liposomal doxorubicin increases radiofrequency ablation–induced tumor destruction by increasing cellular oxidative and nitrative stress and accelerating apoptotic pathways. Radiology 2010;255(1):62–74. Link, Google Scholar2 Curley SA. Radiofrequency ablation of malignant liver tumors. Oncologist 2001;6(1):14–23. Crossref, Medline, Google Scholar3 Chen MH, Yang W, Yan Ket al.. Large liver tumors: protocol for radiofrequency ablation and its clinical application in 110 patients—mathematic model, overlapping mode, and electrode placement process. Radiology 2004;232(1):260–271. Link, Google Scholar4 Goldberg SN, Girnan GD, Lukyanov ANet al.. Percutaneous tumor ablation: increased necrosis with combined radiofrequency ablation and intravenous liposomal doxorubicin in a rat breast tumor model. Radiology 2002;222(3):797–804. Link, Google Scholar5 Goldberg SN, Kamel IR, Kruskal JBet al.. Radiofrequency ablation of hepatic tumors: increased tumor destruction with adjuvant liposomal doxorubicin therapy. AJR Am J Roentgenol 2002;179(1):93–101. Crossref, Medline, Google Scholar6 Doxil. Centocor Ortho Biotech Products. http://www.doxil.com/assets/DOXIL_PI_Booklet.pdf. Accessed September 2009. Google Scholar7 Rivera E. Liposomal anthracyclines in metastatic breast cancer: clinical update. Oncologist 2003;8(suppl 2):3–9. Crossref, Medline, Google ScholarArticle HistoryPublished online: Mar 10 2010Published in print: Apr 2010 FiguresReferencesRelatedDetailsRecommended Articles Therapeutic Effects of CT-guided Radiofrequency Ablation with Concurrent Platinum-Doublet Chemotherapy in a Rabbit VX2 Lung Tumor ModelRadiology2016Volume: 283Issue: 2pp. 391-398Targeting STAT3 to Suppress Systemic Pro-Oncogenic Effects from Hepatic Radiofrequency AblationRadiology2017Volume: 286Issue: 2pp. 524-536Hepatic Thermal Ablation: Effect of Device and Heating Parameters on Local Tissue Reactions and Distant Tumor GrowthRadiology2016Volume: 281Issue: 3pp. 782-792Radiofrequency Ablation Followed by Surgical Excision versus Lumpectomy for Early Stage Breast Cancer: A Randomized Phase II Clinical TrialRadiology2018Volume: 289Issue: 2pp. 317-324Science to Practice: Molecular-targeted Drug Delivery in Combination with Radiofrequency Ablation of Liver Cancer: A Magic Bullet?Radiology2017Volume: 285Issue: 2pp. 333-335See More RSNA Education Exhibits Novel Image-Guided Micro-Invasive Percutaneous Treatments of Breast Lesions: Where Do We Stand?Digital Posters2019The Fast and the Furious: Rapid Progression of HCC After Locoregional Therapy — A Tri-Institutional Collaboration on Imaging PatternsDigital Posters2018Imaging Follow-Up After Radiofrequency Ablation (RFA) in Patients with Early Stage Non-Small Cell Lung Cancer (NSCLC): An Experience-Based Pictorial ReviewDigital Posters2018 RSNA Case Collection Solitary breast plasmacytomaRSNA Case Collection2021AIDS-associated Kaposi sarcomaRSNA Case Collection2020Medication Related Osteonecrosis of the Jaw RSNA Case Collection2021 Vol. 255, No. 1 Metrics Altmetric Score PDF download