Kinetics of indocyanine green removal from blood can be used to predict the size of the area removed by radiofrequency ablation of hepatic nodules.
OBJECTIVE
The size of radiofrequency ablation (RFA) in the liver can be negatively influenced by the surrounding blood flow. The indocyanine green (ICG) test can be used to evaluate the effective blood flow in the liver, and distance from the hilus can affect local blood flow. The aim of this study was to assess whether the ICG test or distance from the hilus could be used to predict the size of the ablated area in liver by RFA treatment of hepatocellular carcinoma (HCC) nodules.


METHODS
The RFA measurements of 44 HCC nodules in 39 patients were retrospectively studied. Cases were included if they met the following criteria: (i) no catheter treatment before RFA; (ii) no movement of the RFA device; (iii) strict ablation time; and (iv) only one ablation. In all patients, ICG-R15 testing was done immediately before RFA and the initial therapeutic efficacy was evaluated by dynamic computed tomography scanning 2-5 days after RFA. The correlation between the maximum size of the RFA area and the ICG test results or the distance of the target area from the hilus (site of first portal vein divergence) were analyzed statistically.


RESULTS
The ICG-R15 result was significantly correlated with the maximum diameter of the ablated area both in 2 cm-electrode tip length (R2 = 0.35, P = 0.0012), and in 3 cm-tip length (R2 = 0.26, P = 0.0377). Multiple-regression analysis showed that the electrode tip length (P = 0.0010) and ICG-R15 (P = 0.0046) were independent factors that could predict the maximum diameter of the RFA area.


CONCLUSIONS
The results of ICG testing can be used to predict the size of the area that will be ablated at a target liver site before RFA treatment.
Sato
Shuichi
S
Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Shimane, Japan. bbsato@med.shimane-u.ac.jp
Miyake
Tatsuya
T
Mishiro
Tomoko
T
Furuta
Kohichiro
K
Azumi
Takane
T
Oshima
Naoki
N
Takahashi
Yoshiko
Y
Rumi
Mohammad A K
MA
Ishihara
Shunnji
S
Adachi
Kyoichi
K
Amano
Yuji
Y
Kinoshita
Yoshikazu
Y
D000368:Aged; D000704:Analysis of Variance; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000601:surgery*; D017115:Catheter Ablation; D004396:Coloring Agents / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007208:Indocyanine Green / Q000493:pharmacokinetics*; D008099:Liver / Q000098:blood supply / Q000601:surgery*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011237:Predictive Value of Tests; D011379:Prognosis; D012039:Regional Blood Flow; D012044:Regression Analysis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D004396:Coloring Agents; D007208:Indocyanine Green