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Small Hepatocellular Carcinoma: Comparison of Radio-frequency Ablation and Percutaneous Microwave Coagulation Therapy¹

¹ From the Departments of Diagnostic Imaging and Nuclear Medicine (T.S., Y.M., F.A., K.I., J.K.) and Gastroenterological Surgery (Y.I., Y.Y.), Kyoto University Graduate School of Medicine, 54-Kawaharacho, Shogoin, Sakyoku, Kyoto 606-8507, Japan. Received April 16, 2001; revision requested May 11; revision received July 24; accepted September 7. Address correspondence to T.S. (e-mail: ksj@kuhp.kyoto-u.ac.jp).

PURPOSE: To evaluate the effectiveness of radio-frequency (RF) ablation and percutaneous microwave coagulation (PMC) for treatment of hepatocellular carcinoma (HCC).

MATERIALS AND METHODS: Seventy-two patients with 94 HCC nodules were randomly assigned to RF ablation and PMC groups. Thirty-six patients with 48 nodules were treated with RF ablation, and 36 patients with 46 nodules were treated with PMC. Therapeutic effect, residual foci of untreated disease, and complications of RF ablation and PMC were prospectively evaluated with statistical analyses.

RESULTS: The number of treatment sessions per nodule was significantly lower in the RF ablation group than in the PMC group (1.1 vs 2.4; P < .001). Complete therapeutic effect was achieved in 46 (96%) of 48 nodules treated with RF ablation and in 41 (89%) of 46 nodules treated with PMC (P = .26). Major complications occurred in one patient treated with RF ablation and in four patients treated with PMC (P = .36). During follow-up (range, 6–27 months), residual foci of untreated disease were seen in four of 48 nodules treated with RF ablation and in eight of 46 nodules treated with PMC. No significant difference in rates of residual foci of untreated disease was noted (P = .20, log-rank test).

CONCLUSION: RF ablation and PMC thus far have had equivalent therapeutic effects, complication rates, and rates of residual foci of untreated disease. However, RF tumor ablation can be achieved with fewer sessions.

© RSNA, 2002

Index terms: Liver, CT, 761.1211, 761.12112, 761.12113, 761.12114, 761.12115 • Liver neoplasms, 761.323, 761.33 • Liver neoplasms, therapy, 761.1269 • Microwaves, 761.1269 • Radiofrequency (RF) ablation, 761.1269

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