Radiofrequency ablation of liver tumors using a novel bipolar device

Radiofrequency ablation (RFA) is now an established tool for treating unresectable liver tumors. Monopolar RFA is currently the accepted standard. However, the variability of the ablation shape and size impedes their further advancement. For this study, we were interested in the evaluation of a new bipolar device for technical feasibility.

We have treated 6 patients [5 with hepatocellular carcinoma (HCC) one with metastatic disease] with a total of 7 tumors (6 HCCs, a solitary metastasis), using a new bipolar RFA device consisting of two separate needles, each with deployable electrodes. The treatment approaches included two percutaneous, three laparoscopic, and one open surgical. Average tumor size was 2.5 cm. Follow-up examinations were performed at intervals of 3 months and included computed tomography, (18)fluorodeoxyglucose positron emission tomography, magnetic resonance imaging and B-mode ultrasound.

All tumors could be ablated successfully. Electrode placement was accurate and visualization in transabdominal, laparoscopic, or intraoperative ultrasound was excellent. Because of the requirement of positioning two needles simultaneously, particularly in the laparoscopic RFA, the procedures were more time-consuming (average, 104 minutes) than placing a single needle. Local tumor control after a follow-up of 6 months was 100%. No major complication occurred.

Successful ablation of liver tumors, using the new bipolar device, is feasible and without complications. The procedure is technically demanding; however, local tumor control seems to be superior, as compared to other RFA devices. The long-term success of the procedure has yet to be evaluated.