Small hepatocellular carcinoma: safety and efficacy of single high-dose percutaneous acetic acid injection for treatment.
OBJECTIVE
To evaluate the safety and efficacy of single high-dose percutaneous acetic acid injection (PAI) for treatment of small (<3-cm-diameter) hepatocellular carcinoma (HCC).


METHODS
Eighteen patients with HCC (22 nodules; diameter range, 1.5-3.0 cm) underwent single PAI. With ultrasonographic or computed tomographic (CT) guidance, 4-11 mL of 50% acetic acid was slowly injected into the center of the nodule through a skinny multiple-side-hole needle. Follow-up was performed with helical contrast material-enhanced CT. Complications of high-dose PAI were recorded.


RESULTS
Seventeen nodules showed no local recurrence (follow-up, 6-29 months) after single PAI. At a mean follow-up of 15.6 months, mean tumor diameter was 2.1 cm and mean injected volume was 6.4 mL. Four nodules showed residual tumor (mean tumor diameter, 2.6 cm; mean injected volume, 5.8 mL). The mean ratio of injected to estimated volume of acetic acid was 1.21 in cases of successful single PAI and 0.72 in cases of local recurrence (P < .001). One patient with preexistent right portal venous thrombosis died of hepatic failure 37 days after PAI. Other complications included severe pain (11%), high fever (4%), and segmental wedge infarction (4%).


CONCLUSIONS
Single high-dose PAI is safe and effective for treatment of small HCC.
Liang
H L
HL
Department of Radiology, Kaohsiung Veterans General Hospital, Taiwan.
Yang
C F
CF
Pan
H B
HB
Lai
K H
KH
Cheng
J S
JS
Lo
G H
GH
Chen
C K
CK
Lai
P H
PH
D019342:Acetic Acid / Q000008:administration & dosage* / Q000009:adverse effects; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015552:Injections, Intralesional / Q000295:instrumentation; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000188:drug therapy; D014057:Tomography, X-Ray Computed / Q000295:instrumentation; D016896:Treatment Outcome
D019342:Acetic Acid