title: Radiofrequency ablation combined with chemoembolization for intermediate-sized (3-5 cm) hepatocellular carcinomas under dual guidance of biplane fluoroscopy and ultrasonography.
abstract: OBJECTIVE
  To assess the technical feasibility and local efficacy of percutaneous radiofrequency ablation (RFA) combined with transcatheter arterial chemoembolization (TACE) for an intermediate-sized (3-5 cm in diameter) hepatocellular carcinoma (HCC) under the dual guidance of biplane fluoroscopy and ultrasonography (US).
  
  
  METHODS
  Patients with intermediate-sized HCCs were treated with percutaneous RFA combined with TACE. RFA was performed under the dual guidance of biplane fluoroscopy and US within 14 days after TACE. We evaluated the rate of major complications on immediate post-RFA CT images. Primary technique effectiveness rate was determined on one month follow-up CT images. The cumulative rate of local tumor progression was estimated with the use of Kaplan-Meier method.
  
  
  RESULTS
  Twenty-one consecutive patients with 21 HCCs (mean size: 3.6 cm; range: 3-4.5 cm) were included. After TACE (mean: 6.7 d; range: 1-14 d), 20 (95.2%) of 21 HCCs were visible on fluoroscopy and were ablated under dual guidance of biplane fluoroscopy and US. The other HCC that was poorly visible by fluoroscopy was ablated under US guidance alone. Major complications were observed in only one patient (pneumothorax). Primary technique effectiveness was achieved for all 21 HCCs in a single RFA session. Cumulative rates of local tumor progression were estimated as 9.5% and 19.0% at one and three years, respectively.
  
  
  CONCLUSIONS
  RFA combined with TACE under dual guidance of biplane fluoroscopy and US is technically feasible and effective for intermediate-sized HCC treatment.
authors.affiliation: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea.
authors.forename: Ji Hye
authors.initials: JH
authors.lastname: Min
authors.forename: Min Woo
authors.initials: MW
authors.lastname: Lee
authors.forename: Dong Ik
authors.initials: DI
authors.lastname: Cha
authors.forename: Yong Hwan
authors.initials: YH
authors.lastname: Jeon
authors.forename: Sung Wook
authors.initials: SW
authors.lastname: Shin
authors.forename: Sung Ki
authors.initials: SK
authors.lastname: Cho
authors.forename: Hyunchul
authors.initials: H
authors.lastname: Rhim
authors.forename: Hyo K
authors.initials: HK
authors.lastname: Lim
mesh_terms: D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D003131:Combined Modality Therapy; D018450:Disease Progression; D004317:Doxorubicin / Q000008:administration & dosage; D004998:Ethiodized Oil / Q000008:administration & dosage; D005240:Feasibility Studies; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications; D015641:Radiography, Interventional; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D000903:Antibiotics, Antineoplastic; D000970:Antineoplastic Agents; D004998:Ethiodized Oil; D004317:Doxorubicin
keywords: Fluoroscopy; Hepatocellular carcinoma; Radiofrequency ablation; Transcatheter arterial chemoembolization; Ultrasonography