title: Ablation of large HCCs using a new saline-enhanced expandable radiofrequency device().
abstract: OBJECTIVE
  Evaluation of a new device designed to achieve large volumes of necrosis in hepatocellular carcinoma (HCC) nodules by application of radiofrequency ablation (RFA).
  
  
  METHODS
  29 consecutive patients with 31 HCC nodules ≥3 cm in diameter (range 3-7.5 cm; mean diameter 5.5 cm) underwent ultrasound (US) guided percutaneous RFA using an expandable electrode with 7 active arrays and saline injection designed to create tissue ablation in areas of up to 7 cm (Starburst XLi-enhanced RFA device). Treatment was performed in general anesthesia (6 patients) or deep sedation (23 patients). Treatment efficacy was assessed by three-phase contrast-enhanced computed tomography (CT) and bimonthly US follow-up.
  
  
  RESULTS
  One to three electrode insertions (mean number 1.6) were performed in each patient. CT showed complete necrosis in 23/31 HCC nodules (74%) in 22 patients. Follow-up of these 22 patients ranged from 2 to 15 months (mean time 8.3 months). In 6/22 patients (28%) intrahepatic recurrence occurred within 5-10 months (mean time 8.3 months). Major complications were post-ablation syndrome in 7/29 (24%), peritoneal effusion in 4/29 (14%), pleural effusion in 2/29 (7%) and transient obstructive jaundice in 1/29 (3.4%) patients. One patient died 6 months after treatment because of tumor progression.
  
  
  CONCLUSIONS
  In the treatment of large HCC nodules, Starburst XLi-enhanced is an effective and safe device.
authors: Department of Hepatology and Interventional Ultrasound, San Giovanni di Dio Hospital, ASL NA3 Frattamaggiore, Naples, Italy.
authors: L
authors: L
authors: Tarantino
authors: I
authors: I
authors: Sordelli
authors: V
authors: V
authors: Nocera
authors: A
authors: A
authors: Piscopo
authors: C
authors: C
authors: Ripa
authors: D
authors: D
authors: Parmeggiani
authors: P
authors: P
authors: Sperlongano
keywords: Hepatocellular carcinoma; Interventional procedure; Radiofrequency Ablation; Ultrasound
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