Radiofrequency ablation of liver cancers adjacent to the gallbladder without gallbladder isolation under contrast-enhanced ultrasound monitoring: a preliminary study

Abstract

Purpose: The purpose of this study was to investigate the feasibility, safety and efficacy of intra-procedural contrast-enhanced ultrasound (CEUS) monitoring of the radiofrequency ablation (RFA) of liver cancers adjacent to gallbladder (GB) without GB isolation. Materials and methods: From May 2016 to July 2017, patients with liver cancers adjacent to GB (10 mm) who intended to undergo ultrasound-guided RFA without GB isolation in our hospital were prospectively enrolled. During the RFA procedures, CEUS was employed to evaluate the therapeutic response and the perfusion of the intact GB wall. The outcomes of GB and liver cancers were followed up and recorded. Results: 23 patients (18 male, 5 female) with 23 liver cancers (mean 18 mm, range 8-34 mm) adjacent to GB were enrolled. There were 12 tumors that abutted the GB while 11 tumors located within 10 mm of the GB. After the RFA procedures, intra-procedural CEUS evaluation demonstrated the perfusion of the GB wall was intact in all 23 patients and technical success rate of RFA was 100% (23/23). According to the contrast-enhanced CT/MR one month after RFA, the technical efficacy rate was 100% (23/23). During the follow-up period (range: 12-23 months, median: 17 months), no local tumor progression occurred and no major complications arised. Overall survival at 1-year was 100%. Thickening of GB wall was detected in 11 patients. The thickness of GB wall returned to the pre-ablation level in five patients. Conclusion: CEUS-monitored RFA of liver cancers adjacent to GB without GB isolation was feasible, safe and effective.

Conspicuousness and recurrence related factors of ultrasound-guided microwave ablation in the treatment of benign thyroid nodules

“…Thermal ablation includes laser ablation (LA), radiofrequency ablation (RFA), high-intensity focused ultrasound (HIFU) and microwave ablation (MWA), among which RFA is the most common [ 15 ]. RFA has been routinely used for the treatment of liver, vascular and other diseases [ 16 ]. In addition, RFA is also effective in the treatment of benign thyroid nodules, but it has been reported that it is less effective in the treatment of solid nodules [ 17 ].…”

Case Report: Ultrasound-Guided Percutaneous Microwave Ablation of Focal Nodular Hyperplasia in a 9-Year-Old Girl

“…To date, thermal ablation for FNH has only been reported in adults (14). Our team has also reported (15) the application of ultrasound-guided ablation for lesions near the gallbladder, thus avoiding the need for cholecystectomy. Accordingly, we chose to perform ultrasound-guided percutaneous MWA for this patient.…”

Computed tomography-guided radiofrequency ablation combined with transarterial embolization assisted by a three-dimensional visualization ablation planning system for hepatocellular carcinoma in challenging locations: a preliminary study

“…Therefore, in the present study, we retrospectively reviewed whether the combination of RFA and previous TAE (1-2 days before) could minimize LTP and increase OS rates. It is a challenge to perform RFA for HCC in these highrisk locations, including the hepatic dome, subcapsular area, gastrointestinal tract, or gallbladder, among others [23][24][25][26], because the ablation volume must be limited to avoid damage to surrounding organs. Therefore, we applied a 3DVAPS to assist with RFA for HCC to achieve multiple ablation spheres of a fixed size covering the target and to observe the spatial location relationship between the tumor and surrounding vital organs more intuitively.…”