Anatomical ablation for small hepatocellular carcinomas using multiple applicators: a preliminary study

Cancer Imaging

Research Article

Jung-Hwan Yoon¹  Yoon Jun Kim¹  Su Jong Yu¹  Hee Soo Kim²  Jeong Hee Yoon²  Jae Hyun Kim²  Ijin Joo²  Jeong Min Lee³ 

[1] Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea;Department of Radiology, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, 03080, Seoul, Republic of Korea;Department of Radiology, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, 03080, Seoul, Republic of Korea;Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea;

关键词: Tumor ablation;    Multiple applicators;    Image fusion;    Anatomical ablation;    Hepatocellular carcinoma;   

DOI  :  10.1186/s40644-023-00597-0

 received in 2023-03-14, accepted in 2023-08-02,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundAnatomical ablation, defined as thermal ablation of tumor-bearing small portal territories, may provide excellent local tumor control in peripherally-located small hepatocellular carcinomas (HCC), which has been a major concern with percutaneous ablation alone.PurposeTo evaluate the technical feasibility and therapeutic outcomes of anatomical ablation using multiple radiofrequency (RF) applicators for the ablation of tumor-bearing small portal territories of peripherally-located small (≤ 4 cm) HCCs.Materials and methodsPatients with peripherally-located single HCCs (≤ 4 cm) to be treated with anatomical ablation using multiple RF applicators between January 2020 and March 2022 were enrolled in this prospective study. Anatomical ablation was performed for the index tumor under real-time US-CT/MR fusion imaging guidance, with one or two clustered electrode needles placed across the tumor-bearing portal vein branches. Technical success and complications of anatomical ablations were assessed. Cumulative incidence of local tumor progression (LTP) and recurrence-free survival were estimated using the Kaplan–Meier method.ResultsFifty-five HCCs (mean size, 1.77 ± 0.59 cm) in 55 participants (mean age, 66.4 ± 7.7 years; 39 men, 16 women) were treated with anatomical ablation; 98.2% (54/55) technical success was achieved. No major complications were noted. Among the 55 participants, LTP occurred in only one patient who had experienced technical failure of anatomical ablation. Estimated 1- and 2-year cumulative incidences of LTP were 0% and 3.7%, respectively. Five patients developed intrahepatic remote recurrence during the median follow-up period of 19.2 months (range, 3.7–28.8 months); therefore, estimated 1- and 2-year recurrence-free survival was 91.7% and 85.0%, respectively.ConclusionAnatomical ablation using multiple RF applicators provided the excellent results of local tumor control in patients with peripherally-located small (≤ 4 cm) HCCs.Trial registrationclinicaltrial.gov identifier: NCT05397860.

【 授权许可】

CC BY   
© International Cancer Imaging Society (ICIS) 2023

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