Lipiodol and dye at the site of ablation decreases during RFA.
OBJECTIVE
Intrahepatic metastasis is one of the serious complications of radiofrequency ablation (RFA) therapy for hepatocellular carcinoma. The aim of this study was to investigate how liver tissue could be disseminated during the RFA procedure with different devices and protocols in an in vivo porcine model.


METHODS
Three pigs underwent RFA procedures using 2 different devices: needles that could be expanded (LeVeen needle) and those that could not (cool-tip needle). A LeVeen needle was used with a single-step full extension method or a stepwise extension method. Before RFA, a mixture of lipiodol and blue dye was injected intrahepatically into a precoagulated area. After the ablation procedure, the specimen was cut to evaluate the amount of dye remaining in the ablated region and the distribution of the dye outside the ablated area.


RESULTS
The stepwise extension method resulted in the disappearance of the smallest amount of the dye and lipiodol at the ablation site, compared with the full extension method and cool-tip needle. Dye was found at sites distant from the ablated area in all cases using the cool-tip needle, but in none with the stepwise extension method.


CONCLUSIONS
The stepwise procedure using the expandable needle can reduce tumor cell scattering, which can cause intrahepatic metastasis, compared with other methods.
Hirakawa
Miharu
M
Department of Hepatology, Toranomon Hospital, Tokyo, Japan.
Ikeda
Kenji
K
Kawamura
Yusuke
Y
Kobayashi
Masahiro
M
Hosaka
Tetsuya
T
Yatsuji
Hiromi
H
Sezaki
Hitomi
H
Akuta
Norio
N
Saitoh
Satoshi
S
Suzuki
Fumitaka
F
Suzuki
Yoshiyuki
Y
Arase
Yasuji
Y
Kumada
Hiromitsu
H
D000818:Animals; D017115:Catheter Ablation / Q000009:adverse effects* / Q000379:methods*; D004396:Coloring Agents / Q000378:metabolism*; D005260:Female; D007459:Iodized Oil / Q000378:metabolism*; D008099:Liver / Q000601:surgery*; D009362:Neoplasm Metastasis / Q000517:prevention & control; D013194:Staining and Labeling / Q000379:methods*; D013552:Swine
D004396:Coloring Agents; D007459:Iodized Oil