Department for Microinvasive Therapy (SIP), Medical University Innsbruck, Anichstr. 35 6020, Innsbruck, Austria.
Cardiovasc Intervent Radiol. 2011 Aug;34(4):852-6. doi: 10.1007/s00270-010-9966-z. Epub 2010 Aug 24.
To describe the technique of percutaneous stereotactic radiofrequency ablation (SRFA) and its application in a patient with an unresectable multifocal intrahepatic cholangiocarcinoma (ICC).
A 72-year-old man presented with two nodules of an ICC with a maximum diameter of 10 and 4 cm, respectively. To produce overlapping ablation areas and cover the entire tumor volume, 18 paths for the placement of radiofrequency ablation (RFA) probes at multiple locations were planned on 2D and 3D reconstructions of the computed tomographic (CT) data. The 15-gauge coaxial needles were advanced through the aiming device to the preplanned depth. A control CT fused to the planning CT data confirmed correct needle placements. RFA was performed with an impedance-based multiple-electrode RFA system. Fusion of the contrast-enhanced control CT with the planning CT showed an appropriate zone of ablation.
Besides a mild asymptomatic pleural effusion, no complications occurred. Twenty-seven months after the first RFA, two new small distant liver metastases were successfully treated by SRFA. Currently, 38 months after diagnosis and 36 months after the first SRFA, the patient is free of detectable disease.
SRFA seems to offer an effective treatment option in selected patients with even unresectable ICC.
描述经皮立体定向射频消融（SRFA）技术及其在无法切除的多灶性肝内胆管细胞癌（ICC）患者中的应用。
一名 72 岁男性，表现为两个直径分别为 10cm 和 4cm 的 ICC 结节。为了产生重叠的消融区域并覆盖整个肿瘤体积，在 CT 数据的二维和三维重建上规划了 18 个位置的射频消融（RFA）探针放置路径。15 号同轴针通过定位装置推进到预定的深度。与计划 CT 数据融合的对照增强 CT 确认了正确的针位。使用基于阻抗的多电极 RFA 系统进行 RFA。与计划 CT 融合的增强对照 CT 显示出适当的消融区域。
除了轻度无症状性胸腔积液外，无其他并发症发生。第一次 RFA 后 27 个月，两个新的小远处肝转移灶成功地接受了 SRFA 治疗。目前，在诊断后 38 个月和第一次 SRFA 后 36 个月，患者无明显疾病。
SRFA 似乎为即使无法切除的 ICC 患者提供了一种有效的治疗选择。
