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Radiofrequency thermal ablation with expandable needle of focal liver malignancies: complication report

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Abstract

The aim of this study was to describe type and rate of complications in a series of patients with liver tumors treated by the radiofrequency (RF) expandable system. A total of 166 patients, 114 with hepatocellular carcinoma (HCC; 92 small HCC, 22 large) and 52 with liver metastasis, were treated by the percutaneous RF expandable system. In large HCCs, RF ablation was performed after tumor ischemia (TAE or balloon stop flow of the hepatic artery). Major complications were those that delayed hospital discharge, with or without additional medical procedures or treatments. Minor complications did not require an additional hospital stay. No deaths occurred. Among 151 patients followed, there were 7 (4.6%) early major complications—severe pain with session interruption in 3 cases, capsular necrosis in 1 case, 1 abdominal wall necrosis, 1 dorsal burning, 1 peritoneal hemorrhage—and 3 (1.9%) delayed major complications: sterile fluid collection at the site of the treated tumor in 2 cases and cutaneous seeding in 1 case. There were 49 (32.5%) minor complications. The complication rate is similar to that observed after percutaneous alcohol injection (PEI). With the cooled system, the complication rate is seemingly lower but that may well be due to a different definition of major complications. The seeding rate after expandable system ablation is lower than after PEI. It is the same as or lower than that in other series of patients treated by the cooled system.

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References

  1. Buscarini L, Fornari F, Rossi S (1992) Interstitial radiofrequency hyperthermia in the treatment of small hepatocellular carcinoma: percutaneous sonography-guidance of electrode needle. In: Anderegg A, Despland PA, Otto R, Henner H (eds) Ultraschall-diagnostik 91. Springer, Berlin Heidelberg NewYork, pp 218–222

  2. Rossi S, Di Stasi M, Buscarini E, Cavanna L, Quaretti P, Squassante E, Garbagnati F, Buscarini L (1995) Percutaneous radiofrequency interstitial thermal ablation in the treatment of small hepatocellular carcinoma. Cancer J Sci Am 1:73–81

    PubMed  Google Scholar 

  3. Rossi S, Di Stasi M, Buscarini E, Quaretti P, Garbagnati F, Squassante L, Paties CT, Silverman DE, Buscarini L (1996) Percutaneous RF interstitial thermal ablation in the treatment of hepatic cancer. AJR 167:759–768

    CAS  Google Scholar 

  4. Livraghi T, Vettori C, Lazzaroni S (1991) Liver metastases: results of percutaneous ethanol injection. Radiology 179:709–712

    CAS  PubMed  Google Scholar 

  5. Buscarini L, Rossi S, Di Stasi M, Buscarini E (1996) Percutaneous radiofrequency interstitial thermal ablation of hepatocellular carcinoma (abstract). Radiology 201:267–268

    Google Scholar 

  6. Lorentzen T (1996) A cooled needle electrode for radiofrequency tissue ablation: thermodynamic aspects of improved performance compared with conventional needle design. Acad Radiol 3:556–563

    CAS  PubMed  Google Scholar 

  7. Buscarini L, Buscarini E, Di Stasi M, Vallisa D, Quaretti P, Rocca A (2001) Percutaneous radiofrequency ablation of small hepatocellular carcinoma: long-term results. Eur Radiol 11:914–921

    PubMed  Google Scholar 

  8. Solbiati L, Livraghi T, Goldberg SN, Ierace T, Meloni F, Dellanoce M, Cova L, Halpern EF, Gazelle GS (2001) Percutaneous radio-frequency ablation of hepatic metastases from colorectal cancer: long-term results in 117 patients. Radiology 221:159–166

    CAS  PubMed  Google Scholar 

  9. Livraghi T, Goldberg SN, Lazzaroni S, Meloni F, Solbiati L, Gazelle GS (1999) Small hepatocellular carcinoma: treatment with radio-frequency ablation vs ethanol injection. Radiology 210:655–661

    CAS  PubMed  Google Scholar 

  10. Goldberg SN, Solbiati L, Hahn PF, Cosman E, Conrad JE, Fogle R, Gazelle GS (1998) Large-volume tissue ablation with radio-frequency by using a clustered, internally-cooled electrode technique: laboratory and clinical experience in liver metastases. Radiology 209:371–379

    CAS  PubMed  Google Scholar 

  11. Miao Y, Yu J, Zhang H, Baert A, Marchal G (2001) An ex vivo study on radio-frequency tissue ablation: increased lesion size by using an “expandable-wet” electrode. Eur Radiol 11:1841–1847

    Article  CAS  PubMed  Google Scholar 

  12. Buscarini L, Buscarini E, Di Stasi M, Quaretti P, Zangrandi A (1999) Percutaneous radio-frequency thermal ablation combined with transcatheter arterial embolization in the treatment of large hepatocellular carcinoma. Ultraschall Med 20:47–53

    Article  CAS  PubMed  Google Scholar 

  13. Denys Al, De Baere T, Mahe C, Sabourin JC, Sa Cunha A, Germain S, Roche A (2001) Radio-frequency tissue ablation of the liver: effects of vascular occlusion on lesion diameter and biliary and portal damages in a pig model. Eur Radiol 11:2102–2108

    Article  CAS  PubMed  Google Scholar 

  14. Livraghi T. Solbiati L, Meloni F, Scott-Gazelle G, Halpern EF, Goldberg SN (2003) Treatment of focal liver tumors with percutaneous radio-frequency ablation: complications encountered in a multicenter study. Radiology 226:441–451

    PubMed  Google Scholar 

  15. Llovet JM, Vilana R, Brù C, Bianchi L, Salmeron JM, Boix L, Ganau S, Sala M, Pagès M, Ayuso C, Solé M, Rodés J, Bruix J (2001) Increased risk of tumor seeding after percutaneous radio-frequency ablation for single hepatocellular carcinoma. Hepatology 33:1124–1129

    Article  CAS  PubMed  Google Scholar 

  16. Pugh RNH, Murray-Lyon IM, Dawson JL, Pietroni LC, Williams R (1973) Transection of the oesophagus for bleeding oesophageal varices. Br J Surg 60:646–649

    CAS  PubMed  Google Scholar 

  17. Lafortune M, Madore F, Patriquin H, Breton G (1991) Segmental anatomy of the liver: a sonographic approach to the Couinaud nomenclature. Radiology 181:443–448

    CAS  PubMed  Google Scholar 

  18. Allgaier P, Deibert P, Zuher I, Olsehewski M, Blum HE (1999) Percutaneous radio-frequency interstitial thermal ablation of small hepatocellular carcinoma. Lancet 353:1676–1677

    Article  CAS  PubMed  Google Scholar 

  19. Curley SA, Izzo F, Delrio P, Ellis LM, Granchi JM, Vallone P, Fiore F, Pignata S, Daniele B, Cremona F (1999) Radio-frequency ablation of unresectable primary and metastatic hepatic malignancies: results in 123 patients. Ann Surg 230:1–8

    Article  CAS  PubMed  Google Scholar 

  20. Choi D, Lim KH, Kim SH, Lee WJ, Jang HJ, Lee JY, Paik SW, Koh KC, Lee JH (2000) Hepatocellular carcinoma treated with percutaneous radio-frequency ablation: usefulness of power Doppler US with a microbubble contrast agent in evaluating therapeutic response: preliminary results. Radiology 217:558–563

    CAS  PubMed  Google Scholar 

  21. Curley S, Izzo F, Ellis LM, Vauthey JN, Vallone P (2000) Radio-frequency ablation of hepatocellular cancer in 110 patients with cirrhosis. Ann Surg 232:381–391

    CAS  Google Scholar 

  22. Livraghi T, Giorgio A, Marin G, Salmi A, De Sio I, Bolondi L, Pompili M, Brunello F, Lazzaroni, Torzilli G, Zucchi A (1995) Hepatocellular carcinoma and cirrhosis in 746 patients: long-term results of percutaneous ethanol injection. Radiology 197:101–108

    CAS  PubMed  Google Scholar 

  23. Di Stasi M, Buscarini L, Livraghi T, Giorgio A, Salmi A, De Sio I, Brunello F, Solmi L, Caturelli E, Magnolfi F, Caremani M, Filice C (1997) Percutaneous ethanol injection in the treatment of hepatocellular carcinoma. A multicenter survey of evaluation practices and complication rates. Scand J Gastroenterol 32:1168–1173

    PubMed  Google Scholar 

  24. Cotton PB, Lehman G, Vennes J, Geenen JE, Russell RC, Meyers WC, Liguory C, Nickl N (1991) Endoscopic sphincterotomy complications and their management: an attempt at consensus. Gastrointest Endosc 37:383–393

    CAS  PubMed  Google Scholar 

  25. Ishii H, Okada S, Okusaka T, Yoshimori M, Nakasuka H, Shimada K, Yamasaki S, Nakanishi Y, Sakamoto M (1998) Needle tract implantation of hepatocellular carcinoma after percutaneous ethanol injection. Cancer 82:1638–1642

    Article  CAS  PubMed  Google Scholar 

  26. Roussel F, Dalion J, Benozio M (1989) The risk of tumoral seeding in needle biopsies. Acta Cytol 33:936–939

    CAS  PubMed  Google Scholar 

  27. Buscarini E, Foroni R, Rossi S, Di Stasi M, Silva M, Marinone G, Degli Antoni G, Buscarini L (1997) Fine needles with echo markers: increasing cell dragging during biopsy. Acta Cytol 41:1246–1249

    CAS  PubMed  Google Scholar 

  28. Malik ST, Naylor MS, East N, Oliff A, Balkwill FR (1990) Cells secreting tumor necrosis factor show enhanced metastasis in nude mice. Eur J Cancer 26:1031–1034

    CAS  PubMed  Google Scholar 

  29. Livraghi T (2001) Tumor dissemination after radio-frequency ablation of hepatocellular carcinoma (letter). Hepatology 34:608–609

    Article  CAS  Google Scholar 

  30. Buscarini L (1998) Complications of abdominal interventional ultrasound: the dissemination risk. JEMU 19:149–152

    Google Scholar 

  31. Motoo Y, Okai T, Matsui O, Ohta H, Sawabu N (1991) Liver atrophy after transcatheter arterial embolization and percutaneous ethanol injection therapy for a minute hepatocellular carcinoma. Gastrointest Radiol 16:164–166

    CAS  PubMed  Google Scholar 

  32. Yoshikawa J, Matsui O, Kadoya M, Gabata T, Miyayama S, Takahashi S, Takashima T, Kobayashi K (1995) Hepatocellular carcinoma: CT appearance of parenchymal changes after percutaneous ethanol injection therapy. Radiology 194:107–111

    CAS  PubMed  Google Scholar 

  33. Livraghi T, Benedini V, Lazzaroni S, Meloni F, Torzilli G, Vettori C (1998) Long-term results of single-session percutaneous ethanol injection in patients with large hepatocellular carcinoma. Cancer 83:48–57

    Article  CAS  PubMed  Google Scholar 

  34. De Baere T, Denys A, Wood B, Lassau N, Kardache M, Vilgrain V, Menu Y, Roche A (2001) Radio-frequency liver ablation: experimental comparative study of water-cooled vs expandable systems. AJR 176:187–192

    PubMed  Google Scholar 

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Correspondence to Elisabetta Buscarini.

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Buscarini, E., Buscarini, L. Radiofrequency thermal ablation with expandable needle of focal liver malignancies: complication report. Eur Radiol 14, 31–37 (2004). https://doi.org/10.1007/s00330-003-1990-9

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  • DOI: https://doi.org/10.1007/s00330-003-1990-9

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