Biochemical and Hematologic Changes after Percutaneous Radiofrequency Ablation of Liver Tumors: Experience in 83 Procedures

Çizginer, Sevdenur; Tatlı, Servet; Hurwitz, Shelley; Tuncalı, Kemal; vanSonnenberg, Eric; Silverman, Stuart G.

doi:10.1016/j.jvir.2010.12.033

Cited by 9 publications

(7 citation statements)

References 24 publications

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“…Thrombocytopenia after cryoablation has been described elsewhere [49]. A decrease in platelet count after hepatic tumor ablations can also be seen after heat-based ablations [50]. We encountered disseminated intravascular coagulation after three procedures, all of which occurred after the ablation of tumors larger than 3 cm (two larger than 4 cm) that necessitated including a large volume of adjacent normal hepatic parenchyma into the ablation zone.…”

Section: Discussionmentioning

confidence: 74%

“…For all patients with preprocedural renal insufficiency, or if the postprocedural serum myoglobin level exceeds 1000 ng/mL, we administer alkalinized fluids (5% dextrose solution with 150 mEq/L sodium bicarbonate, 100–150 mL/hr for 24 hours) to decrease the risk of acute kidney injury. As with thrombocytopenia, myoglobinuria may also occur after heat-based ablations [50]. …”

Section: Discussionmentioning

confidence: 99%

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Percutaneous Image-Guided Cryoablation of Hepatic Tumors: Single-Center Experience With Intermediate to Long-Term Outcomes

Glazer

Tatlı

Shyn

et al. 2017

American Journal of Roentgenology

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OBJECTIVE The purpose of this article is to report our intermediate to long-term outcomes with image-guided percutaneous hepatic tumor cryoablation and to evaluate its technical success, technique efficacy, local tumor progression, and adverse event rate. MATERIALS AND METHODS Between 1998 and 2014, 299 hepatic tumors (243 metastases and 56 primary tumors; mean diameter, 2.5 cm; median diameter, 2.2 cm; range, 0.3–7.8 cm) in 186 patients (95 women; mean age, 60.9 years; range, 29–88 years) underwent cryoablation during 236 procedures using CT (n = 126), MRI (n = 100), or PET/CT (n = 10) guidance. Technical success, technique efficacy at 3 months, local tumor progression (mean follow-up, 2.5 years; range, 2 months to 14.6 years), and adverse event rates were calculated. RESULTS The technical success rate was 94.6% (279/295). The technique efficacy rate was 89.5% (231/258) and was greater for tumors smaller than 4 cm (93.4%; 213/228) than for larger tumors (60.0%; 18/30) (p < 0.0001). Local tumor progression occurred in 23.3% (60/258) of tumors and was significantly more common after the treatment of tumors 4 cm or larger (63.3%; 19/30) compared with smaller tumors (18.0%; 41/228) (p < 0.0001). Adverse events followed 33.8% (80/236) of procedures and were grade 3–5 in 10.6% (25/236) of cases. Grade 3 or greater adverse events more commonly followed the treatment of larger tumors (19.5%; 8/41) compared with smaller tumors (8.7%; 17/195) (p = 0.04). CONCLUSION Image-guided percutaneous cryoablation of hepatic tumors is efficacious; however, tumors smaller than 4 cm are more likely to be treated successfully and without an adverse event.

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Percutaneous Image-Guided Cryoablation of Hepatic Tumors: Single-Center Experience With Intermediate to Long-Term Outcomes

Glazer

Tatlı

Shyn

et al. 2017

American Journal of Roentgenology

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“…Generally, serum AST and ALT levels are elevated when hepatocytes are injured and become necrotic by various causes, such as hepatotoxic drugs, virus-related necroinflammation, or physical injury including hyperthermia by RFA. 16 , 17 AST is widely distributed not only in the liver but also in the heart and skeletal muscle, while ALT is known to be a more specific test for detecting acute liver disease. 19 , 20 , 21 In particular, AST activity is about three times that of ALT in hepatocytes.…”

Section: Discussionmentioning

confidence: 99%

“…The serum bilirubin level was observed to be elevated immediately after RFA, as has been noted in several previous studies, 25 , 26 but serum alkaline phosphatase increased slowly and its peak was observed 1 week after ablation. These results are supported by a previous study and are potentially consistent with minor injury of the small bile duct and cholestasis resulting from hepatocyte necrosis, although there was no gross evidence of biliary injury on follow-up CT. 17 …”

Section: Discussionmentioning

confidence: 99%

“… 12 , 13 To monitor acute liver injury following treatment, biochemical and hematologic profiles are usually obtained both pre- and post-procedure. There have been few studies concerning biochemical and hematologic changes after RFA, 14 , 15 , 16 , 17 and it is well known that ablation volume correlates with acute laboratory changes in non-cirrhotic patients. However, it is unclear how the severity of liver cirrhosis is related to acute hematologic and biochemical changes after RFA.…”

Section: Introductionmentioning

confidence: 99%

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Alteration of laboratory findings after radiofrequency ablation of hepatocellular carcinoma: relationship to severity of the underlying liver disease and the ablation volume

et al. 2015

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Background/AimsTo investigate sequential changes in laboratory markers after radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC) and the relationship of these changes to the severity of the underlying liver disease.MethodsThis retrospective analysis included 65 patients (44 males, 21 females) who underwent RFA of HCC. Hematologic and biochemical markers were assessed at the pre-RFA period and 1 day, 2-3 days, and 1-2 weeks after RFA. We classified the subjects into two groups: Child-Pugh A (n=41) and Child-Pugh B (n=24). The ablative margin volume (AMV) of each patient was measured. We analyzed the changes in laboratory profiles from the baseline, and investigated whether these laboratory changes were correlated with the AMV and the Child-Pugh classification.ResultsMost of the laboratory values peaked at 2-3 days after RFA. AMV was significantly correlated with changes in WBC count, hemoglobin level, and serum total bilirubin level (Pearson's correlation coefficient, 0.324-0.453; P<0.05). The alanine aminotransferase (ALT) level varied significantly over time (P=0.023).ConclusionsMost of the measured laboratory markers changed from baseline, peaking at 2-3 days. The ALT level was the only parameter for which there was a significant difference after RFA between Child-Pugh A and B patients: it increased significantly more in the Child-Pugh A patients.

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Feasibility of Percutaneous Intrahepatic Split by Microwave Ablation (PISA) After Portal Vein Embolization for Hypertrophy of Future Liver Remnant: The Radiological Stage-1 ALPPS

Lunardi

Cervelli

Volterrani

et al. 2018

Cardiovasc Intervent Radiol

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Biochemical and Hematologic Changes after Percutaneous Radiofrequency Ablation of Liver Tumors: Experience in 83 Procedures

Cited by 9 publications

References 24 publications

Percutaneous Image-Guided Cryoablation of Hepatic Tumors: Single-Center Experience With Intermediate to Long-Term Outcomes

Percutaneous Image-Guided Cryoablation of Hepatic Tumors: Single-Center Experience With Intermediate to Long-Term Outcomes

Alteration of laboratory findings after radiofrequency ablation of hepatocellular carcinoma: relationship to severity of the underlying liver disease and the ablation volume

Feasibility of Percutaneous Intrahepatic Split by Microwave Ablation (PISA) After Portal Vein Embolization for Hypertrophy of Future Liver Remnant: The Radiological Stage-1 ALPPS

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