title: Transarterial chemoembolization using drug eluting beads and subsequent percutaneous MR-guided radiofrequency ablation in the therapy of intermediate sized hepatocellular carcinoma.
abstract: OBJECTIVE
  To evaluate safety, efficacy, survival and recurrence-free survival of transarterial chemoembolization (TACE) with drug eluting (DC) beads combined with MR-guided radiofrequency (RF) ablation for the treatment of hepatocellular carcinomas (HCC) larger than 3 cm.
  
  
  METHODS
  This retrospective study was approved by the institutional review board. 20 patients (69.6 years ± SD 8.8) with HCC underwent DC Bead TACE and subsequent MR-guided RF ablation. Treatment interval varied between 5 and 15 days. Mean HCC diameter was 39 mm ± SD 7 mm (range 31-50mm). Rates of recurrence-free survival and overall survival were estimated using the Kaplan-Meier method.
  
  
  RESULTS
  Technical success rate, primary and secondary technical effectiveness rate were 100%, 90% and 95%, respectively. Local tumour progression developed in one patient. Cumulative survival rates at 1, 3 and 5 years were 90% (Confidence Interval [CI]: 67%-97%), 50% (CI: 29%-70%), 27% (CI: 11%-51%) respectively. Median survival time was 37.4 months. During follow up (mean: 39.1 months ± SD 22.4; range 5-84 months), tumour progression in untreated liver developed in 14 cases. Cumulative recurrence-free survival rates at 1, 3 and 5 years were 48% (CI: 27-69%), 16% (5-39%), 16% (5-39%) respectively. Median recurrence-free survival time was 10.7 months. One major complication occurred due to misdiagnosed local recurrence.
  
  
  CONCLUSIONS
  In conclusion, we demonstrated that MR-guided RF ablation with subsequent DC Bead TACE is safe and effective in local tumour control in patients with intermediate sized HCC.
authors: Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076 Tübingen, Germany. Electronic address: ruediger.hoffmann@med.uni-tuebingen.de.
authors: Rüdiger
authors: R
authors: Hoffmann
authors: Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076 Tübingen, Germany. Electronic address: hansjoerg.rempp@med.uni-tuebingen.de.
authors: Hansjörg
authors: H
authors: Rempp
authors: Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076 Tübingen, Germany. Electronic address: roland.syha@med.uni-tuebingen.de.
authors: Roland
authors: R
authors: Syha
authors: Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076 Tübingen, Germany. Electronic address: dominik.ketelsen@med.uni-tuebingen.de.
authors: Dominik
authors: D
authors: Ketelsen
authors: Department of Radiology, Minimally Invasive Therapies and Nuclearmedicine, SLK-Kliniken Heilbronn GmbH, Am Gesundbrunnen 20-26, 74078 Heilbronn, Germany. Electronic address: philippe.pereira@slk-kliniken.de.
authors: Philippe L
authors: PL
authors: Pereira
authors: Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076 Tübingen, Germany. Electronic address: claus.claussen@med.uni-tuebingen.de.
authors: Claus D
authors: CD
authors: Claussen
authors: Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076 Tübingen, Germany. Electronic address: stephan.clasen@med.uni-tuebingen.de.
authors: Stephan
authors: S
authors: Clasen
mesh_terms: D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000628:therapy*; D017115:Catheter Ablation / Q000379:methods*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D003131:Combined Modality Therapy; D003287:Contrast Media; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D008113:Liver Neoplasms / Q000473:pathology / Q000628:therapy*; D053783:Magnetic Resonance Imaging, Interventional; D008297:Male; D008863:Microspheres; D009942:Organometallic Compounds; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000903:Antibiotics, Antineoplastic; D003287:Contrast Media; D009942:Organometallic Compounds; C090600:gadobutrol; D015251:Epirubicin; D007472:Iohexol; C038192:iopromide
keywords: Drug eluting beads; Hepatocellular carcinoma; Interventional MRI; RF ablation; Transarterial chemoembolization