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Vascular and Interventional Radiology |
1 From the Department of Radiology, Ospedale Civile, Vimercate, Italy (T.L., F.M.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (S.N.G.); Department of Radiology, Ospedale Generale, Busto Arsizio, Italy (L.S., T.I.); Decision Analysis and Technology Assessment Group, Department of Radiology, Massachusetts General Hospital, Zero Emerson Pl, Suite 2H, Boston, MA 02114 (G.S.G.); and Department of Health Policy and Management, Harvard School of Public Health, Boston, Mass (G.S.G.). From the 1999 RSNA scientific assembly. Received July 5, 2000; revision requested August 16; revision received October 17; accepted November 1. Address correspondence to G.S.G.
PURPOSE: To evaluate the authors’ initial experience in a consecutive series of 24 patients with breast cancer liver metastases treated with radio-frequency (RF) ablation.
MATERIALS AND METHODS: Twenty-four consecutive patients with 64 metastases measuring 1.0–6.6 cm in diameter (mean, 1.9 cm) underwent ultrasonography-guided percutaneous RF ablation with 18-gauge, internally cooled electrodes. Treatment was performed with the patient under conscious sedation and analgesia or general anesthesia. A single lesion was treated in 16 patients, and multiple lesions were treated in eight patients. Follow-up with serial computed tomography ranged from 4 to 44 months (mean, 10 months; median, 19 months).
RESULTS: Complete necrosis was achieved in 59 (92%) of 64 lesions. Among the 59 lesions, complete necrosis required a single treatment session in 58 lesions (92%) and two treatment sessions in one lesion (2%). In 14 (58%) of 24 patients, new metastases developed during follow-up. Ten (71%) of these 14 patients developed new liver metastases. Currently, 10 (63%) of 16 patients whose lesions were initially confined to the liver are free of disease. One patient died of progressive brain metastases. No major complications occurred. Two minor complications were observed.
CONCLUSION: On the basis of preliminary study results, percutaneous RF ablation appears to be a simple, safe, and effective treatment for focal liver metastases in selected patients with breast cancer.
Index terms: Breast neoplasms, metastases, 00.324 • Liver, CT, 761.12112 • Liver neoplasms, secondary, 761.332 • Radiofrequency (RF) ablation, 761.1269
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