Prospective study of a 'popping' sound during percutaneous radiofrequency ablation for hepatocellular carcinoma.
OBJECTIVE
To prospectively evaluate the occurrence of a 'popping' sound during radiofrequency (RF) ablation for hepatocellular carcinoma (HCC) and its association with early tumor progression and patient survival.


METHODS
Seventy-six patients with 100 tumors underwent RF ablation by using an internally cooled electrode. A popping sound was defined as an audible sound or tactile vibration detected by the operator during RF ablation. Follow-up ranged from 6 to 38 months (mean, 19 months) and included 3-6 month ultrasonography, serum alpha-fetoprotein measurements, and computed tomography or magnetic resonance imaging. Early local and distant intrahepatic tumor progression within 12 months and survival were analyzed.


RESULTS
A popping sound occurred during 58 of the 100 (58%) tumor ablations. Primary technique effectiveness was achieved in 97 of the 100 (97%) tumors. Major complications occurred in 2 of the 76 patients (2.6%). The cumulative rate of early local tumor progression was 20.8%. At multivariate analysis, early local tumor progression was associated with tumor size larger than 3 cm (odds ratio [OR] = 4.08, P = .012) and inversely associated with a popping sound (OR = 0.267, P = .026). The cumulative rate of early distant intrahepatic tumor progression was 21.4%, and the cumulative survival of the whole cohort at 6, 12, 18, and 24 months was 98.7%, 96%, 92.7%, and 83.6%, respectively. A popping sound was not significantly associated with either early distant intrahepatic tumor progression (P = .341) or patient survival (P = .975).


CONCLUSIONS
A popping sound during RF ablation is not associated with an increased risk of early tumor progression or poorer patient survival.
Fernandes
Mark Lee
ML
Liver Research Unit, Chang Gung Memorial Hospital, Taipei, Taiwan.
Lin
Chen-Chun
CC
Lin
Chun-Jung
CJ
Chen
Wei-Ting
WT
Lin
Shi-Ming
SM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects*; D016009:Chi-Square Distribution; D018450:Disease Progression; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009622:Noise; D011312:Pressure; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014732:Vibration; D000509:alpha-Fetoproteins / Q000378:metabolism
C097353:AFP protein, human; D000509:alpha-Fetoproteins