Ultrasound-Guided Percutaneous Microwave Coagulation Therapy with a “Cooled-tip Needle” for the Treatment of Hepatocellular Carcinoma Adjacent to the Gallbladder

Pan, Weidong; Zheng, Rongqin; Lin, Nan; Fang, Heping; Liu, Bo; Tang, Zhaofeng; Deng, Meihai; Xu, Rui‐hua

doi:10.1007/s10620-009-1053-4

Cited by 7 publications

(4 citation statements)

References 23 publications

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“…Although no perfusion defects of the GB wall were observed by CEUS assessment during RFA, thickening of the GB wall was demonstrated in 47.8% (11/23) of the enrolled patients soon after RFA. This thickening was slightly higher than that reported previously (2 6 $ 41%) [13][14][15][17][18][19][27][28][29]. More cases abutting the GB (52%, 12/ 23), parallel insertion of the electrode and closer proximity to the GB (no less than 5 mm) might be considered causes of these differences.…”

Section: Discussionmentioning

confidence: 49%

“…On the other hand, thermometric needles inserted in the GB fossa or laparoscopy monitoring are used to predict potential thermal damage to the GB [15,16]. Moreover, cholecystectomy immediately after thermal ablation is another invasive method of preventing major complications due to potential thermal damage [17]. However, these above additional invasive measures may increase the complexity, trauma and cost of RFA.…”

Section: Introductionmentioning

confidence: 99%

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

Long

Yan

et al. 2018

International Journal of Hyperthermia

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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.

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Section: Discussionmentioning

confidence: 49%

Section: Introductionmentioning

confidence: 99%

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

Long

Yan

et al. 2018

International Journal of Hyperthermia

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“…The microwave probe with water-cooled tip could enlarge its coagulation field in one-point ablation (from 1.6×2.4 cm to 4.7×5.2 cm), to reduce tumor load and the number of TACE performers. 17 , 18 The recommended ablation area of the apparatus that we used for PMCT was 4.5–5.0 cm in long-axis direction.…”

Section: Discussionmentioning

confidence: 99%

The effect of lipiodol deposition in HCC after TACE on the necrosis range of PMCT

Sun¹,

Ni²,

Jiang³

et al. 2017

OTT

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ObjectiveTo study the impact of lipiodol deposition in the lesion of hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE) on the necrosis area of percutaneous microwave coagulation therapy (PMCT).Materials and methodsA total of 44 patients with HCC with 56 nodules, with a size ranging from 1.5 to 3.5 cm, was selected in our study. About 23 patients (26 nodules) underwent PMCT treatment only as Group A and 21 patients (30 nodules) were treated by PMCT-combined TACE as Group B. All patients underwent PMCT with single-electrode and one-point ablation. Paired t-test was used to analyze pre- and postoperatively the volume of tumor and the necrosis volume after PMCT. Independent t-test was used to compare the difference in the necrosis area between two groups (α=0.05).ResultsAll patients underwent PMCT or PMCT combined with TACE successfully. The tumor and necrosis size of Group A was 16.29±19.23 cm3 and 17.98±18.49 cm3 (P=0.650), and 11.95±12.78 cm3 and 16.60±11.70 cm3 of Group B (P=0.017). There was no significant difference on necrosis volume between the two groups (P=0.581). The necrosis area of Group B was larger than the size of the tumor (P=0.017), but the ablation area of the two groups was smaller than the theoretic area (P=0.001). (The theoretic area means that the necrosis area of ablation should be 1.0 cm larger than the tumor in diameter.)ConclusionPMCT combined with TACE could enlarge the ablation area, but will not lead to an ideal necrosis area than the PMCT alone. The lipiodol deposition in the tumor lesion may hinder the expansion of the heating field. Therefore, further research was needed.

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“…[59] Image artifacts must be recognized and carefully distinguished from anatomical structure to ensure the accuracy of the location of the needle tip. [66] Some issue will be further investigated like the impact of MCT on the systemic immunity of the HCC patient. [34] At present, there are very few reports on the association of MCT used in the treatment of HCC and its modification of patients' systemic immunity.…”

Section: Limitations and Perspectvesmentioning

confidence: 99%

Microwave coagulation therapy of hepatocellular carcinoma

Guan¹

2015

Hepatoma Res

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Ultrasound-Guided Percutaneous Microwave Coagulation Therapy with a “Cooled-tip Needle” for the Treatment of Hepatocellular Carcinoma Adjacent to the Gallbladder

Abstract: Our results suggest that combined treatment comprising both laparoscopic cholecystectomy and subsequent percutaneous microwave coagulation therapy is an effective and safe approach for patients with small (<5 cm) hepatocellular carcinomas that are adjacent to the gallbladder.

Cited by 7 publications

References 23 publications

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

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

The effect of lipiodol deposition in HCC after TACE on the necrosis range of PMCT

Microwave coagulation therapy of hepatocellular carcinoma

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