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(Radiology. 2000;214:761-768.)
© RSNA, 2000

Vascular and Interventional Radiology

Hepatocellular Carcinoma: Radio-frequency Ablation of Medium and Large Lesions1

Tito Livraghi, MD, S. Nahum Goldberg, MD, Sergio Lazzaroni, MD, Franca Meloni, MD, Tiziana Ierace, MD, Luigi Solbiati, MD and G. Scott Gazelle, MD, MPH, PhD

1 From the Department of Radiology, Ospedale Civile, Via Cereda, 23, 20059 Vimercate, Italy (T.L., F.M.); the Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (S.N.G.); the Department of Internal Medicine, Ospedale San Biagio, Clusone, Italy (S.L.); the Department of Radiology, Ospedale Generale, Busto Arsizio, Italy (T.I., L.S.); and the Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (G.S.G.). From the 1998 RSNA scientific assembly. Received March 10, 1999; revision requested April 27; revision received June 17; accepted July 21. Supported in part by Radionics. Address reprint requests to T.L. (e-mail: lalivra@tin.it).

PURPOSE: To study local therapeutic efficacy, side effects, and complications of radiofrequency (RF) ablation in the treatment of medium and large hepatocellular carcinoma (HCC) lesions in patients with cirrhosis or chronic hepatitis.

MATERIALS AND METHODS: One-hundred fourteen patients who were under conscious sedation or general anesthesia had 126 HCCs greater than 3.0 cm in diameter treated with RF by using an internally cooled electrode. Eighty tumors were medium (3.1–5.0 cm), and 46 were large (5.1–9.5 cm). The mean diameter for all tumors was 5.4 cm. At imaging, 75 tumors were considered noninfiltrating, and 51 were considered infiltrating.

RESULTS: Complete necrosis was attained in 60 lesions (47.6%), nearly complete (90%–99%) necrosis in 40 lesions (31.7%), and partial (50%–89%) necrosis in the remaining 26 lesions (20.6%). Medium and/or noninfiltrating tumors were treated successfully significantly more often than large and/or infiltrating tumors. Two major complications (death, hemorrhage requiring laparotomy) and five minor complications (self-limited hemorrhage, persistent pain) were observed. The single death was due to a break in sterile technique rather than to the RF procedure itself.

CONCLUSION: RF ablation appears to be an effective, safe, and relatively simple procedure for the treatment of medium and large HCCs.

Index terms: Hepatitis, 761.291 • Liver, cirrhosis, 761.794 • Liver, CT, 761.12112, 761.12115 • Liver, interventional procedures, 761.1269, 761.47 • Liver, US, 761.12983, 761.12985 • Liver neoplasms, therapy, 761.1269, 761.323, 761.47 • Radiofrequency (RF) ablation, 761.1269, 761.47




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