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CardioVascular and Interventional Radiology

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01-01-2008 | Clinical Investigation

Factors Limiting Complete Tumor Ablation by Radiofrequency Ablation

Authors: Erwan Paulet, Christophe Aubé, Patrick Pessaux, Jerome Lebigot, Emilie Lhermitte, Frederic Oberti, Anne Ponthieux, Paul Calès, Catherine Ridereau-Zins, Philippe L. Pereira

Published in: CardioVascular and Interventional Radiology | Issue 1/2008

Abstract

The purpose of this study was to determine radiological or physical factors to predict the risk of residual mass or local recurrence of primary and secondary hepatic tumors treated by radiofrequency ablation (RFA). Eighty-two patients, with 146 lesions (80 hepatocellular carcinomas, 66 metastases), were treated by RFA. Morphological parameters of the lesions included size, location, number, ultrasound echogenicity, computed tomography density, and magnetic resonance signal intensity were obtained before and after treatment. Parameters of the generator were recorded during radiofrequency application. The recurrence-free group was statistically compared to the recurrence and residual mass groups on all these parameters. Twenty residual masses were detected. Twenty-nine lesions recurred after a mean follow-up of 18 months. Size was a predictive parameter. Patients’ sex and age and the echogenicity and density of lesions were significantly different for the recurrence and residual mass groups compared to the recurrence-free group (p < 0.05). The presence of an enhanced ring on the magnetic resonance control was more frequent in the recurrence and residual mass groups. In the group of patients with residual lesions, analysis of physical parameters showed a significant increase (p < 0.05) in the time necessary for the temperature to rise. In conclusion, this study confirms risk factors of recurrence such as the size of the tumor and emphasizes other factors such as a posttreatment enhanced ring and an increase in the time necessary for the rise in temperature. These factors should be taken into consideration when performing RFA and during follow-up.

Fan ST, Lo CM, Liu CL, et al. (1999) Hepatectomy for hepatocellular carcinoma: toward zero hospital deaths. Ann Surg 229:322–330PubMedCrossRef

Fong Y, Sun RL, Jarnagin W, Blumgart LH (1999) An analysis of 412 cases of hepatocellular carcinoma at a Western center. Ann Surg 229:790–799, discussion 799–800PubMedCrossRef

Lu DS, Yu NC, Raman SS, et al. (2005) Percutaneous radiofrequency ablation of hepatocellular carcinoma as a bridge to liver transplantation. Hepatology 41:1130–1137PubMedCrossRef

Solbiati L, Ierace T, Tonolini M, Osti V, Cova L (2001) Radiofrequency thermal ablation of hepatic metastases. Eur J Ultrasound 13:149–158PubMedCrossRef

Rhim H, Goldberg SN, Dodd GD 3rd, et al. (2001) Essential techniques for successful radio-frequency thermal ablation of malignant hepatic tumors. Radiographics 21:17–35

Livraghi T (2003) Radiofrequency ablation, PEIT, and TACE for hepatocellular carcinoma. J Hepatobil Pancreat Surg 10:67–76

Lencioni R, Cioni D, Crocetti L, Bartolozzi C (2004) Percutaneous ablation of hepatocellular carcinoma: state-of-the-art. Liver Transpl 10:S91–S97PubMedCrossRef

Goldberg SN, Charboneau JW, Dodd GD 3rd, Dupuy DE, Gervais DA, Gillams AR, Kane RA, Lee FT Jr, Livraghi T, McGahan JP, Rhim H, Silverman SG, Solbiati L, Vogl TJ, Wood BJ (2003) Image-guided tumor ablation: proposal for standardization of terms and reporting criteria. International Working Group on Image-Guided Tumor Ablation. Radiology 228(2):335–345PubMedCrossRef

Goldberg SN, Gazelle GS (2001) Radiofrequency tissue ablation: physical principles and techniques for increasing coagulation necrosis. Hepatogastroenterology 48:359–367PubMed

10.

Curley SA (2001) Radiofrequency ablation of malignant liver tumors. Oncologist 6:14–23PubMedCrossRef

11.

McGhana JP, Dodd GD 3rd (2001) Radiofrequency ablation of the liver: current status. Am J Roentgenol 176:3–16

12.

de Baere T, Elias D, Dromain C, et al. (2000) Radiofrequency ablation of 100 hepatic metastases with a mean follow-up of more than 1 year. Am J Roentgenol 175:1619–1625

13.

Chopra S, Dodd GD 3rd, Chintapalli KN, Leyendecker JR, Karahan OI, Rhim H (2001) Tumor recurrence after radiofrequency thermal ablation of hepatic tumors: spectrum of findings on dual-phase contrast-enhanced CT. Am J Roentgenol 177:381–387

14.

Veit P, Antoch G, Stergar H, Bockisch A, Forsting M, Kuehl H (2006) Detection of residual tumor after radiofrequency ablation of liver metastasis with dual-modality PET/CT: initial results. Eur Radiol 16(1):80–87PubMedCrossRef

15.

Rossi S, Buscarini E, Garbagnati F, et al. (1998) Percutaneous treatment of small hepatic tumors by an expandable RF needle electrode. Am J Roentgenol 170:1015–1022

16.

Curley SA, Izzo F, Delrio P, et al. (1999) Radiofrequency ablation of unresectable primary and metastatic hepatic malignancies: results in 123 patients. Ann Surg 230:1–8PubMedCrossRef

17.

Curley SA, Izzo F, Ellis LM, Nicolas Vauthey J, Vallone P (2000) Radiofrequency ablation of hepatocellular cancer in 110 patients with cirrhosis. Ann Surg 232:381–391PubMedCrossRef

18.

Livraghi T, Solbiati L (2001) [Percutaneous treatment: radiofrequency ablation of hepatic metastases in colorectal cancer]. Tumori 87:S69PubMed

19.

Livraghi T, Goldberg SN, Lazzaroni S, et al. (2000) Hepatocellular carcinoma: radio-frequency ablation of medium and large lesions. Radiology 214:761–768PubMed

20.

Siperstein A, Garland A, Engle K, et al. (2000) Laparoscopic radiofrequency ablation of primary and metastatic liver tumors. Technical considerations. Surg Endosc 14:400–405PubMedCrossRef

21.

Siperstein A, Garland A, Engle K, et al. (2000) Local recurrence after laparoscopic radiofrequency thermal ablation of hepatic tumors. Ann Surg Oncol 7:106–113PubMedCrossRef

22.

Lencioni RA, Allgaier HP, Cioni D, et al. (2003) Small hepatocellular carcinoma in cirrhosis: randomized comparison of radio-frequency thermal ablation versus percutaneous ethanol injection. Radiology 228:235–240PubMedCrossRef

23.

Choi D, Lim HK, Rhim H, et al. (2007) Percutaneous radiofrequency ablation for early-stage hepatocellular carcinoma as a first-line treatment: long-term results and prognostic factors in a large single-institution series. Eur Radiol 17(3):684–692PubMedCrossRef

24.

Dromain C, de Baere T, Elias D, et al. (2002) Hepatic tumors treated with percutaneous radio-frequency ablation: CT and MR imaging follow-up. Radiology 223:255–262PubMedCrossRef

25.

Mazzaferro V, Battiston C, Perrone S, et al. (2004) Radiofrequency ablation of small hepatocellular carcinoma in cirrhotic patients awaiting liver transplantation: a prospective study. Ann Surg 240:900–909PubMedCrossRef

26.

Lu DS, Yu NC, Raman SS, et al. (2005) Radiofrequency ablation of hepatocellular carcinoma: treatment success as defined by histologic examination of the explanted liver. Radiology 234:954–960PubMedCrossRef

27.

Kim YS, Rhim H, Cho OK, Koh BH, Kim Y (2006) Intrahepatic recurrence after percutaneous radiofrequency ablation of hepatocellular carcinoma: analysis of the pattern and risk factors. Eur J Radiol 59(3):432–441PubMedCrossRef

28.

29.

Lu DS, Raman SS, Vodopich DJ, Wang M, Sayre J, Lassman C (2002) Effect of vessel size on creation of hepatic radiofrequency lesions in pigs: assessment of the “heat sink” effect. Am J Roentgenol 178:47–51

30.

de Baere T (2001) Radiofrequency ablation of the liver. Am J Roentgenol 177:1213–1215

31.

Solazzo SA, Liu Z, Lobo SM, et al. (2005) Radiofrequency ablation: importance of background tissue electrical conductivity—an agar phantom and computer modeling study. Radiology 236:495–502PubMedCrossRef

32.

Livraghi T, Goldberg SN, Lazzaroni S, Meloni F, Solbiati L, Gazelle GS (1999) Small hepatocellular carcinoma: treatment with radio-frequency ablation versus ethanol injection. Radiology 210:655–661PubMed

33.

Solbiati L, Goldberg SN, Ierace T, et al. (1997) Hepatic metastases: percutaneous radio-frequency ablation with cooled-tip electrodes. Radiology 205:367–373PubMed

34.

Berber E, Senagore A, Remzi F, Rogers S, Herceg N, Casto K, Siperstein A (2004) Laparoscopic radiofrequency ablation of liver tumors combined with colorectal procedures. Surg Laparosc Endosc Percutan Tech 15:472–544

35.

Van Duijnhoven FH, Jansen MC, Junggeburt JM, van Hillegersberg R, Rijken AM, van Coevorden F, van der Sijp JR, van Gulik TM, Slooter GD, Klaase JM, Putter H, Tollenaar RA (2006) Factors influencing the local failure rate of radiofrequency ablation of colorectal liver metastases. Ann Surg Oncol 13:651–658PubMedCrossRef

36.

Abdalla EK, Vauthey JN, Ellis LM, et al. (2004) Recurrence and outcomes following hepatic resection, radiofrequency ablation, and combined resection/ablation for colorectal liver metastases. Ann Surg 239(6):818–827PubMedCrossRef

37.

Berber E, Rogers S, Siperstein A (2005) Predictors of survival after laparoscopic radiofrequency thermal ablation of hepatocellular cancer: a prospective study. Surg Endosc 19(5):710–714PubMedCrossRef

38.

Goldberg SN, Gazelle GS, Mueller PR (2000) Thermal ablation therapy for focal malignancy: a unified approach to underlying principles, techniques, and diagnostic imaging guidance. Am J Roentgenol 174:323–331

39.

Inoue T, Shiga J, Machinami R (1992) Direct correlation between sonography and histology of minute malignant hepatic nodule. Pathol Res Pract 188:330–339PubMed

40.

Sheu JC, Chen DS, Sung JL, et al. (1985) Hepatocellular carcinoma: US evolution in the early stage. Radiology 155:463–467PubMed

41.

Ignee A, Weiper D, Schuessler G, Teuber G, Faust D, Dietrich CF (2005) Sonographic characterisation of hepatocellular carcinoma at time of diagnosis. Z Gastroenterol 43:289–294PubMedCrossRef

42.

Amano S, Ebara M, Yajima T, et al. (2003) Assessment of cancer cell differentiation in small hepatocellular carcinoma by computed tomography and magnetic resonance imaging. J Gastroenterol Hepatol 18:273–279PubMedCrossRef

43.

Cady B, Jenkins RL, Steele GD Jr, et al. (1998) Surgical margin in hepatic resection for colorectal metastasis: a critical and improvable determinant of outcome. Ann Surg 227:566–571PubMedCrossRef

44.

Pereira PL, Trubenbach J, Schmidt D (2003) [Radiofrequency ablation: basic principles, techniques and challenges]. Rofo 175:20–27PubMed

45.

Christophi C, Winkworth A, Muralihdaran V, Evans P (1998) The treatment of malignancy by hyperthermia. Surg Oncol 7:83–90PubMedCrossRef

46.

Denys AL, De Baere T, Mahe C, et al. (2001) Radio-frequency tissue ablation of the liver: effects of vascular occlusion on lesion diameter and biliary and portal damages in a pig model. Eur Radiol 11:2102–2108PubMedCrossRef

47.

Yamakado K, Nakatsuka A, Ohmori S, et al. (2002) Radiofrequency ablation combined with chemoembolization in hepatocellular carcinoma: treatment response based on tumor size and morphology. J Vasc Interv Radiol 13:1225–1232PubMedCrossRef

48.

Livraghi T, Goldberg SN, Monti F, et al. (1997) Saline-enhanced radio-frequency tissue ablation in the treatment of liver metastases. Radiology 202:205–210PubMed

49.

Haemmerich D, Staelin ST, Tungjitkusolmun S, Lee FT Jr, Mahvi DM, Webster JG (2001) Hepatic bipolar radio-frequency ablation between separated multiprong electrodes. IEEE Trans Biomed Eng 48:1145–1152PubMedCrossRef

50.

Rhim H, Dodd GD 3rd (1999) Radiofrequency thermal ablation of liver tumors. J Clin Ultrasound 27:221–229PubMedCrossRef

51.

Solbiati L, Livraghi T, Goldberg SN, et al. (2001) Percutaneous radio-frequency ablation of hepatic metastases from colorectal cancer: long-term results in 117 patients. Radiology 221:159–166PubMedCrossRef

52.

Gazelle GS, Goldberg SN, Solbiati L, Livraghi T (2000) Tumor ablation with radio-frequency energy. Radiology 217:633–646PubMed

53.

Choi D, Lim HK, Lee WJ, et al. (2004) Radiofrequency ablation of liver cancer: early evaluation of therapeutic response with contrast-enhanced ultrasonography. Korean J Radiol 5:185–198PubMedCrossRef

54.

Nouso K, Shiraga K, Uematsu S, Okamoto R, Harada R, Takayama S, Kawai W, Kimura S, Ueki T, Okano N, Nakagawa M, Mizuno M, Araki Y, Shiratori Y (2005) Prediction of the ablated area by the spread of microbubbles during radiofrequency ablation of hepatocellular carcinoma. Liver Int 25(5):967–972PubMedCrossRef

55.

Choi D, Lim HK, Lee WJ, Kim SH, Kim YH, Kim SH, Lim JH (2003) Early assessment of the therapeutic response to radio frequency ablation for hepatocellular carcinoma: utility of gray scale harmonic ultrasonography with a microbubble contrast agent. J Ultrasound Med 22(11):1163–1172PubMed

56.

Clasen S, Boss A, Schmidt D, Fritz J, Schraml C, Claussen CD, Pereira PL (2006) Magnetic resonance imaging for hepatic radiofrequency ablation. Eur J Radiol 59(2):140–148PubMedCrossRef

57.

Mahnken AH, Buecker A, Spuentrup E, et al. (2004) MR-guided radiofrequency ablation of hepatic malignancies at 1.5 T: initial results. J Magn Reson Imaging 19:342–348PubMedCrossRef

Title: Factors Limiting Complete Tumor Ablation by Radiofrequency Ablation
Authors: Erwan Paulet
Christophe Aubé
Patrick Pessaux
Jerome Lebigot
Emilie Lhermitte
Frederic Oberti
Anne Ponthieux
Paul Calès
Catherine Ridereau-Zins
Philippe L. Pereira
Publication date: 01-01-2008
Publisher: Springer-Verlag
Published in: CardioVascular and Interventional Radiology / Issue 1/2008
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-007-9208-1

At a glance: The STEP trials

Springer Medicine

Factors Limiting Complete Tumor Ablation by Radiofrequency Ablation

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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