title: Stereotactic radiofrequency ablation (SRFA) of liver lesions: technique effectiveness, safety, and interoperator performance.
abstract: OBJECTIVE
  To evaluate technique effectiveness, safety, and interoperator performance of stereotactic radiofrequency ablation (SRFA) of liver lesions.
  
  
  METHODS
  Retrospective review including 90 consecutive patients from January 2008 to January 2010 with 106 computed tomography-guided SRFA sessions using both single and multiple electrodes for the treatment of 177 lesions: 72 hepatocellular carcinoma (HCC) and 105 metastases with a mean size of 2.9 cm (range 0.5-11 cm). Technique effectiveness and 1-year local recurrence were evaluated by computed tomographic scans. Complications, mortality, and hospital days were recorded. The performance between an experienced and inexperienced interventional radiologist was compared.
  
  
  RESULTS
  The overall technique effectiveness after a single SRFA was 95.5% (93.1% for HCC and 97.1% for metastases). Four of the eight unsuccessfully treated lesions could be retreated (secondary technique effectiveness of 97.7%). Local recurrence at 1 year was 2.9%. Technique effectiveness was significantly different for lesions<5 cm (96.7%) and >5 cm (87.5%) (P=0.044) but not for lesions<3 cm (95.9%) and 3-5 cm (100%). Compared to clear parenchymal property (97.3%), vessel vicinity (93.3%) (P=0.349) and subcapsular (95.2%) (P=0.532) had no, but hollow viscera vicinity (83.3%) had a significantly lower technique effectiveness (P=0.020). Mortality rate was 0.9%. Major complications and hospital days were higher for cirrhosis Child-Pugh B (20%, 7.2 days) than Child-Pugh A (3.1%, 4.7 days) patients and for metastases (5.1%, 4.3 days). There was no significant difference in interoperator performance.
  
  
  CONCLUSIONS
  SRFA allowed for efficient, reliable, and safe ablation of large-volume liver disease.
authors.affiliation: Department of Radiology, SIP-Department of Microinvasive Therapy, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria. gerlig.widmann@i-med.ac.at
authors.forename: Gerlig
authors.initials: G
authors.lastname: Widmann
authors.forename: Peter
authors.initials: P
authors.lastname: Schullian
authors.forename: Marion
authors.initials: M
authors.lastname: Haidu
authors.forename: Reto
authors.initials: R
authors.lastname: Bale
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D003287:Contrast Media; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007902:Length of Stay / Q000706:statistics & numerical data; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D061214:Patient Safety; D011183:Postoperative Complications / Q000401:mortality; D012189:Retrospective Studies; D013238:Stereotaxic Techniques; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014283:Triiodobenzoic Acids / Q000627:therapeutic use
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; C044834:iodixanol