Skip to main content
Erschienen in: European Radiology 9/2010

01.09.2010 | Interventional

Small nodular hepatocellular carcinoma treated by laser thermal ablation in high risk locations: preliminary results

verfasst von: Bruno Caspani, Anna Maria Ierardi, Fabio Motta, Piero Cecconi, Edoardo Fesce, Luca Belli

Erschienen in: European Radiology | Ausgabe 9/2010

Einloggen, um Zugang zu erhalten

Abstract

Objectives

To demonstrate the effectiveness and the safety of laser thermal ablation (LTA) in patients with unresectable hepatocellular carcinoma (HCC) deemed not accessible for other percutaneous procedures (radiofrequency ablation, sclerotherapy).

Methods

From September 2003 to August 2008, 140 patients with HCC nodules were treated. In 49 patients, the lesions were localized in “critical sites”. A total of 29 men and 20 women (age range 51–79 years; Child–Pugh score A = 75.51%, B = 24.49%) with 52 nodules (mean diameter 2.0 ± 1.2 cm) were treated in 95 percutaneous LTA sessions. We compared major and minor complications observed in the two groups of patients. Effectiveness was defined as the percentage of HCCs completely ablated after percutaneous LTA. Follow-up was carried out with computed tomography (CT) at 1, 3, 6, 9, and 12 months.

Results

No major complications or deaths were registered. In a few patients (8.16%), minor complications were observed. No substantial differences were observed on comparing the percentage of minor and major complications in these patients with the remaining patients. A difference in terms of effectiveness was found.

Conclusion

LTA can be considered a safe treatment in “critical nodules”.
Literatur
1.
Zurück zum Zitat Makuuchi M, Kosuge T, Takayama T et al (1993) Surgery for small liver cancers. Semin Surg Oncol 9:298–304CrossRefPubMed Makuuchi M, Kosuge T, Takayama T et al (1993) Surgery for small liver cancers. Semin Surg Oncol 9:298–304CrossRefPubMed
2.
Zurück zum Zitat Mazzaferro V, Ragalia E, Doci R et al (1996) Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Eng J Med 334:693–699CrossRef Mazzaferro V, Ragalia E, Doci R et al (1996) Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Eng J Med 334:693–699CrossRef
3.
Zurück zum Zitat Llovet JM, Fuster J, Bruix J et al (1999) Intention to treat analysis of surgical treatment for early hepatocellular carcinoma: resection versus transplantation. Hepatology 30:1434–1440CrossRefPubMed Llovet JM, Fuster J, Bruix J et al (1999) Intention to treat analysis of surgical treatment for early hepatocellular carcinoma: resection versus transplantation. Hepatology 30:1434–1440CrossRefPubMed
4.
Zurück zum Zitat Livraghi T, Giorgio A, Marin G et al (1995) Hepatocellular carcinoma and cirrhosis in 746 patients: long term results of percutaneous ethanol injection. Radiology 197:101–108PubMed Livraghi T, Giorgio A, Marin G et al (1995) Hepatocellular carcinoma and cirrhosis in 746 patients: long term results of percutaneous ethanol injection. Radiology 197:101–108PubMed
5.
Zurück zum Zitat Ishii H, Okada S, Nose H et al (1996) Local recurrence of hepatocellular carcinoma after percutaneous ethanol injection. Cancer 77:1792–1796CrossRefPubMed Ishii H, Okada S, Nose H et al (1996) Local recurrence of hepatocellular carcinoma after percutaneous ethanol injection. Cancer 77:1792–1796CrossRefPubMed
6.
Zurück zum Zitat Shiina S, Tagawa K, Niwa Y et al (1993) Percutaneous ethanol injection therapy for the treatment of hepatocellular carcinoma: results in 146 patients. AJR Am J Roentgenol 160:1023–1028PubMed Shiina S, Tagawa K, Niwa Y et al (1993) Percutaneous ethanol injection therapy for the treatment of hepatocellular carcinoma: results in 146 patients. AJR Am J Roentgenol 160:1023–1028PubMed
7.
Zurück zum Zitat Ishii H, Okada S, Okusaka T et al (1998) Needle tract implantation of hepatocellular carcinoma after percutaneous ethanol injection. Cancer 82:1638–1642CrossRefPubMed Ishii H, Okada S, Okusaka T et al (1998) Needle tract implantation of hepatocellular carcinoma after percutaneous ethanol injection. Cancer 82:1638–1642CrossRefPubMed
8.
Zurück zum Zitat Yamashita Y, Matsukawa T, Arakawa A et al (1995) US-guided liver biopsy: predicting the effect of interventional treatment of hepatocellular carcinoma. Radiology 196:799–804PubMed Yamashita Y, Matsukawa T, Arakawa A et al (1995) US-guided liver biopsy: predicting the effect of interventional treatment of hepatocellular carcinoma. Radiology 196:799–804PubMed
9.
Zurück zum Zitat Livraghi T, Goldberg SN, Lazzaroni S et al (1999) Small hepatocellular carcinoma: treatment with radiofrequency ablation versus ethanol injection. Radiology 210:655–661PubMed Livraghi T, Goldberg SN, Lazzaroni S et al (1999) Small hepatocellular carcinoma: treatment with radiofrequency ablation versus ethanol injection. Radiology 210:655–661PubMed
10.
Zurück zum Zitat Murakami R, Yoshimatsu S, Yamashita Y et al (1995) Treatment of hepatocellular carcinoma: value of percutaneous microwave coagulation. AJR Am J Roentgenol 164:1159–1164PubMed Murakami R, Yoshimatsu S, Yamashita Y et al (1995) Treatment of hepatocellular carcinoma: value of percutaneous microwave coagulation. AJR Am J Roentgenol 164:1159–1164PubMed
11.
Zurück zum Zitat Pacella CM, Bizzarri G, Ferrari FS et al (1996) Interstitial photocoagulation with laser in the treatment of liver metastases. Radiol Med 92:438–447PubMed Pacella CM, Bizzarri G, Ferrari FS et al (1996) Interstitial photocoagulation with laser in the treatment of liver metastases. Radiol Med 92:438–447PubMed
12.
Zurück zum Zitat Silvermann SG, Tuncali K, Adams DF et al (2000) MR imaging-guided percutaneous cryotherapy of liver tumors: initial experience. Radiology 217:657–664 Silvermann SG, Tuncali K, Adams DF et al (2000) MR imaging-guided percutaneous cryotherapy of liver tumors: initial experience. Radiology 217:657–664
13.
Zurück zum Zitat Wu F, Wang ZB, Chen WZ et al (2004) Extracorporeal high intensity focused untrasound ablation in the treatment of patients with large hepatocellular carcinoma. Ann Surg Onc 11:1061–1069CrossRef Wu F, Wang ZB, Chen WZ et al (2004) Extracorporeal high intensity focused untrasound ablation in the treatment of patients with large hepatocellular carcinoma. Ann Surg Onc 11:1061–1069CrossRef
14.
Zurück zum Zitat Teratani T, Yoshida H, Shiina S et al (2006) Radiofrequency ablation for hepatocellular carcinoma in so-called high risk locations. Hepatology 43:1101–1108CrossRefPubMed Teratani T, Yoshida H, Shiina S et al (2006) Radiofrequency ablation for hepatocellular carcinoma in so-called high risk locations. Hepatology 43:1101–1108CrossRefPubMed
15.
Zurück zum Zitat Sutherland LM, Williams JAR, Padbury RTA et al (2006) Radiofrequency ablation of liver tumors. Arch Surg 141:181–190CrossRefPubMed Sutherland LM, Williams JAR, Padbury RTA et al (2006) Radiofrequency ablation of liver tumors. Arch Surg 141:181–190CrossRefPubMed
16.
Zurück zum Zitat Arienti V, Pretolani S, Pacella CM et al (2008) Complications of laser ablation for hepatocellular carcinoma: a multicentre study. Radiology 246:947–955CrossRefPubMed Arienti V, Pretolani S, Pacella CM et al (2008) Complications of laser ablation for hepatocellular carcinoma: a multicentre study. Radiology 246:947–955CrossRefPubMed
17.
Zurück zum Zitat Bruix J, Sherman M, Llovet JM et al (2001) Clinical management of hepatocellular carcinoma: conclusions of the Barcelona-2000 EASL conference. J Hepatol 35:421–430CrossRefPubMed Bruix J, Sherman M, Llovet JM et al (2001) Clinical management of hepatocellular carcinoma: conclusions of the Barcelona-2000 EASL conference. J Hepatol 35:421–430CrossRefPubMed
18.
Zurück zum Zitat Pacella CM, Bizzarri C, Magnolfi F et al (2001) Laser thermal ablation in the treatment of small hepatocellular carcinoma: results in 74 patients. Radiology 221:712–720CrossRefPubMed Pacella CM, Bizzarri C, Magnolfi F et al (2001) Laser thermal ablation in the treatment of small hepatocellular carcinoma: results in 74 patients. Radiology 221:712–720CrossRefPubMed
19.
Zurück zum Zitat Goldberg SN, Grassi CJ, Cardella JF et al (2005) Image-guided tumour ablation: standardization of terminology and reporting criteria. Radiology 235:728–739CrossRefPubMed Goldberg SN, Grassi CJ, Cardella JF et al (2005) Image-guided tumour ablation: standardization of terminology and reporting criteria. Radiology 235:728–739CrossRefPubMed
20.
Zurück zum Zitat Rossi S, Garbagnati F, Lencioni R et al (2000) Percutaneous radiofrequency thermal ablation of non resectable hepatocellular carcinoma after occlusion of tumour blood supply. Radiology 217:119–126PubMed Rossi S, Garbagnati F, Lencioni R et al (2000) Percutaneous radiofrequency thermal ablation of non resectable hepatocellular carcinoma after occlusion of tumour blood supply. Radiology 217:119–126PubMed
21.
Zurück zum Zitat Whelan WM, Wyman DR, Wilson BC (1995) Investigations of large vessel cooling during interstitial laser heating. Med Phys 22:105–115CrossRefPubMed Whelan WM, Wyman DR, Wilson BC (1995) Investigations of large vessel cooling during interstitial laser heating. Med Phys 22:105–115CrossRefPubMed
22.
Zurück zum Zitat Ghough-Palmer AL, Gedroyc WMW (2008) Laser ablation of hepatocellular carcinoma—a review. World J Gastroenterol 14:7170–7174CrossRef Ghough-Palmer AL, Gedroyc WMW (2008) Laser ablation of hepatocellular carcinoma—a review. World J Gastroenterol 14:7170–7174CrossRef
23.
Zurück zum Zitat Germer CT, Roggan A, Ritz JP et al (1998) Optical properties of native and coagulated human liver tissue and liver metastases in the near infrared range. Lasers Surg Med 23:194–203CrossRefPubMed Germer CT, Roggan A, Ritz JP et al (1998) Optical properties of native and coagulated human liver tissue and liver metastases in the near infrared range. Lasers Surg Med 23:194–203CrossRefPubMed
24.
Zurück zum Zitat Livraghi T, Solbiati L, Meloni MF et al (2003) Treatment of focal liver tumors with percutaneous radio-frequency ablation: complications in a multicentric study. Radiology 226:441–451CrossRefPubMed Livraghi T, Solbiati L, Meloni MF et al (2003) Treatment of focal liver tumors with percutaneous radio-frequency ablation: complications in a multicentric study. Radiology 226:441–451CrossRefPubMed
25.
Zurück zum Zitat Tateishi R, Shiina S, Teratani T et al (2005) Percutaneous radiofrequency ablation for hepatocellular carcinoma. Cancer 103:1201–1209CrossRefPubMed Tateishi R, Shiina S, Teratani T et al (2005) Percutaneous radiofrequency ablation for hepatocellular carcinoma. Cancer 103:1201–1209CrossRefPubMed
26.
Zurück zum Zitat Vilana R, Bruix J, Bru C et al (1992) Tumor size determines the efficacy of percutaneous injection for the treatment of small hepatocellular carcinoma. Hepatology 16:353–357CrossRefPubMed Vilana R, Bruix J, Bru C et al (1992) Tumor size determines the efficacy of percutaneous injection for the treatment of small hepatocellular carcinoma. Hepatology 16:353–357CrossRefPubMed
Metadaten
Titel
Small nodular hepatocellular carcinoma treated by laser thermal ablation in high risk locations: preliminary results
verfasst von
Bruno Caspani
Anna Maria Ierardi
Fabio Motta
Piero Cecconi
Edoardo Fesce
Luca Belli
Publikationsdatum
01.09.2010
Verlag
Springer-Verlag
Erschienen in
European Radiology / Ausgabe 9/2010
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-010-1766-y

Weitere Artikel der Ausgabe 9/2010

European Radiology 9/2010 Zur Ausgabe

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

S3-Leitlinie zu Pankreaskrebs aktualisiert

23.04.2024 Pankreaskarzinom Nachrichten

Die Empfehlungen zur Therapie des Pankreaskarzinoms wurden um zwei Off-Label-Anwendungen erweitert. Und auch im Bereich der Früherkennung gibt es Aktualisierungen.

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

18.04.2024 Pädiatrische Notfallmedizin Nachrichten

Im Choosing-Wisely-Programm, das für die deutsche Initiative „Klug entscheiden“ Pate gestanden hat, sind erstmals Empfehlungen zum Umgang mit Notfällen von Kindern erschienen. Fünf Dinge gilt es demnach zu vermeiden.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.