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liver tumor RF

Radiofrequency liver tumor ablation with a wet electrode

Authors: Dupas BM; Gangi A; Frapas E; Guth S; Leborgne J; Imbert JP

Abstract

  • Purpose: To evaluate the efficiency and the complications of radio frequency ablation of liver tumors with a wet electrode under CT and ultrasound guidance.
  • Method and materials: 170 patients underwent percutaneous RF ablation of 224 liver tumors using a wet electrode with simultaneous saline interstitial infusion at the tip (through side holes) during ablation (Berchtold, Tuttlingen, Germany): 86 patients had hepatocellular carcinoma, 69 colorectal metastases, 12 breast cancer metastases, 1 stromal tumor metastases, 1 melanoma metastases and one cholangiocarcinoma. Patients were not considered operative candidates.  Treatment response was evaluated with helical CT and/or MRI 24 hours after treatment, 1 month and every 3-4 months. Patients were followed for up for 6 to 24 months (mean 11 months).
  • Results: one month after treatment, complete necrosis was obtained in 95.7 % of the lesions < 2,5 cm, 76 % of the lesions ranging from 2.5 to 3.5 cm, and 54 % of the lesions > 3-5 cm (maximum 9 cm). Margins of necrosis were irregular but well delineated. Repeat treatment was performed when partial necrosis was achieved or when local recurrence or new lesions were observed. Major complications occurred in 7 patients with HCC: 3 liver abscess (with one death) and 4 seedings, one in patient with metastases.
  • Conclusions: the wet electrode technique allows an effective and easy radio frequency destruction for lesions  < 2.5 cm, the results are encouraging for lesions > 3.5 cm with overlapping method. Additional advantages of wet electrode, are low cost, hypertonic saline infusion and bipolar electrode possibilities.