Efficacy and safety of radiofrequency ablation of hepatocellular carcinoma in the hepatic dome with the CT-guided extrathoracic transhepatic approach.
OBJECTIVE
The purpose of this study was to determine the efficacy and safety of radiofrequency (RF) ablation for the treatment of hepatocellular carcinoma (HCC) in the hepatic dome with CT-guided extrathoracic transhepatic approach.


METHODS
Fifteen patients with 15 HCCs (size range: 0.8-4 cm, mean size: 1.8 cm) in the hepatic dome were treated by RF ablation using cooled-tip electrodes and with CT-guided extrathoracic transhepatic approach. Therapeutic response of the tumor to RF ablation and procedure-related complications including hepatic injury, hemoperitoneum, and thermal injury of diaphragm were evaluated.


RESULTS
The average number of needle punctures to ensure the correct needle position in the targeted tumor was 3.7 (range: 1-6 punctures). The average ablation time was 14.7 min (range: 8-25 min). Complete necrosis without marginal recurrence after at least 13-month follow-up was attained in 13 tumors (86.7%). There were no major complications related to the procedures. Six patients had shoulder pain that lasted three days to two weeks after the procedures and their symptoms were resolved with conservative treatment.


CONCLUSIONS
RF ablation using CT-guided extrathoracic transhepatic approach is an effective and safe technique for the treatment of HCC in the hepatic dome.
Kim
Young Kon
YK
Department of Diagnostic Radiology, Chonbuk National University Hospital and Medical School, Keum Am Dong, JeonJu, South Korea. jmyr@dreamwiz.com
Kim
Chong Soo
CS
Lee
Jeong Min
JM
Chung
Gyung Ho
GH
Chon
Su Bin
SB
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome