title: Treatment of liver tumours adjacent to hepatic hilum with percutaneous microwave ablation combined with ethanol injection: a pilot study.
abstract: OBJECTIVE
  To evaluate the feasibility, safety and efficacy of ultrasound-guided percutaneous microwave ablation combined with percutaneous ethanol injection in the treatment of liver tumours adjacent to the hepatic hilum.
  
  
  METHODS
  From December 2005 to April 2008, 18 consecutive patients with 18 pathologically proven or clinically diagnosed liver tumours (15 HCCs, three metastatic tumours) adjacent to the hepatic hilum underwent ultrasound-guided percutaneous microwave ablation combined with percutaneous ethanol injection. One or two microwave antennae were inserted and placed at designated places in the tumour. One or two ethanol needles were placed at the tumour periphery near the hepatic hilum. An aliquot of 2-10 mL of absolute ethanol was injected into the tumour at the same time as microwave emission. A thermocouple was placed directly abutting the bile ducts of the hepatic hilum to monitor temperature in real time during ablation to avoid thermal injury.
  
  
  RESULTS
  No more than two sessions were performed to complete the treatment (one session for 10 patients, two sessions for eight, mean 1.4 sessions per patient). Complete ablation was achieved in 94.4% (17 out of 18 cases). In a median follow up of 15 months (range 4 to 27 months, mean 13.5 months), no mortality or complications occurred. Local tumour progression was noted in one patient 12 months after treatment.
  
  
  CONCLUSIONS
  A combination of ultrasound-guided percutaneous microwave ablation and percutaneous ethanol injection assisted with real-time temperature monitoring appears to be feasible and effective in the treatment of liver tumours adjacent to the hepatic hilum, and initial experience with safety is promising.
authors.affiliation: Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, China.
authors.forename: He
authors.initials: H
authors.lastname: Ren
authors.forename: Ping
authors.initials: P
authors.lastname: Liang
authors.forename: Xiaoling
authors.initials: X
authors.lastname: Yu
authors.forename: Yang
authors.initials: Y
authors.lastname: Wang
authors.forename: Tong
authors.initials: T
authors.lastname: Lu
authors.forename: Xin
authors.initials: X
authors.lastname: Li
mesh_terms: D017115:Catheter Ablation / Q000295:instrumentation / Q000379:methods*; D003131:Combined Modality Therapy; D000431:Ethanol / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D010865:Pilot Projects; D013696:Temperature; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D000431:Ethanol