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Anatomical ablation for small hepatocellular carcinomas using multiple applicators: a preliminary study.

Jae Hyun Kim1, Hee Soo Kim1, Jeong Hee Yoon1

  • 1Department of Radiology, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.

Cancer Imaging : the Official Publication of the International Cancer Imaging Society
|August 22, 2023
PubMed
Summary

Anatomical ablation using radiofrequency (RF) applicators offers excellent local tumor control for small hepatocellular carcinomas (HCC). This minimally invasive technique demonstrates high technical success and low recurrence rates in patients with peripheral HCC.

Keywords:
Anatomical ablationHepatocellular carcinomaImage fusionMultiple applicatorsTumor ablation

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Area of Science:

  • Hepatobiliary Surgery
  • Interventional Radiology
  • Oncology

Background:

  • Peripherally-located small hepatocellular carcinomas (HCC) pose challenges for traditional percutaneous ablation.
  • Anatomical ablation, targeting tumor-bearing portal territories, shows promise for improved local tumor control.

Purpose of the Study:

  • To assess the technical feasibility and therapeutic outcomes of anatomical ablation for small HCCs.
  • To evaluate the use of multiple radiofrequency (RF) applicators in this procedure.

Main Methods:

  • Prospective study of 55 patients with small (≤4 cm) peripheral HCCs treated with anatomical ablation.
  • Real-time US-CT/MR fusion imaging guided placement of RF electrodes targeting portal vein branches.
  • Assessment of technical success, complications, local tumor progression (LTP), and recurrence-free survival.

Main Results:

  • High technical success rate of 98.2% (54/55) with no major complications.
  • Excellent local tumor control with a 2-year cumulative incidence of LTP at 3.7%.
  • Estimated 2-year recurrence-free survival was 85.0%.

Conclusions:

  • Anatomical ablation with multiple RF applicators is technically feasible and effective.
  • This method provides excellent local tumor control for peripherally-located small HCCs.
  • It represents a promising minimally invasive treatment option for selected HCC patients.