title: Sonography guided percutaneous radiofrequency ablation of hepatocellular carcinoma: effect of cooperative training on the pretreatment assessment of the operation's feasibility.
abstract: OBJECTIVE
  The aim of this study is to investigate the effects of cooperative training on the pretreatment assessment of the feasibility to perform Ultrasonography (US) guided percutaneous radiofrequency ablation for patients afflicted with hepatocellular carcinoma.
  
  
  METHODS
  In our prospective study, 146 patients with 200 hepatocellular carcinomas were referred for radiofrequency ablation after triage by hepatologists. Three radiologists with different levels of experience performed the planning US before (group I) and after (group II) cooperative training, to evaluate whether radiofrequency ablation was feasible. The feasibility rates considered eligible according to our criteria were evaluated. In addition, we analyzed the reasons for the lack of feasibility were analyzed. The interobserver agreement for the assessment of feasibility before and after training was also calculated.
  
  
  RESULTS
  The overall feasibility rates for both groups was 73%. No significant difference in the feasibility rates was observed. The feasibility rates of each observer for group I were 71% (observer 1), 77% (observer 2) and 70% (observer 3) and those for group II were 73%, 76% and 69%, respectively. In the tumors (n = 164) considered ineligible, the two most common causes for refraining from performing radiofrequency ablation included non-visualization of the tumor (62%) and the absence of a safe route for the percutaneous approach (38%). We found moderate interobserver agreement for all observers before cooperative training and a good agreement after training.
  
  
  CONCLUSIONS
  Although the cooperative training did not affect the feasibility rate of each observer, it improved the interobserver agreement for assessing the feasibility of performing US guided radiofrequency ablation, which may reduce unnecessary admission or delayed treatment.
authors.affiliation: Department of Radiology, Korea University Anam Hospital, Seoul, Korea.
authors.forename: Min Ju
authors.initials: MJ
authors.lastname: Kim
authors.forename: Hyo K
authors.initials: HK
authors.lastname: Lim
authors.forename: Dongil
authors.initials: D
authors.lastname: Choi
authors.forename: Won Jae
authors.initials: WJ
authors.lastname: Lee
authors.forename: Hyun Chul
authors.initials: HC
authors.lastname: Rhim
authors.forename: Seonwoo
authors.initials: S
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000601:surgery*; D017115:Catheter Ablation; D002983:Clinical Competence; D005240:Feasibility Studies; D006801:Humans; D007318:Inservice Training; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D018084:Ultrasonography, Interventional