Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
Int J Clin Oncol. 2013 Feb;18(1):46-53. doi: 10.1007/s10147-011-0340-1. Epub 2011 Oct 22.
We aimed to evaluate therapeutic outcomes of radiofrequency (RF) ablation following intra-arterial iodized-oil injection for hepatocellular carcinomas (HCCs) invisible on ultrasonographic (US) images.
Informed consent was waived for this retrospective study approved by our institutional review board. Sixty-seven consecutive patients with 150 HCCs (mean diameter 1.3 ± 0.6 cm; range 0.5-4.2 cm) received 90 RF sessions following intra-arterial iodized-oil injection. Each patient had at least one HCC invisible on US images. Computed tomography (CT) fluoroscopy-guided RF ablation was performed within 1 week after the injection of iodized oil from feeding arteries of each tumor. Technical success was defined as a planned electrode placement and completion of ablation protocol. Technical success, complications, changes in liver function, local tumor progression, and survival were evaluated.
All HCCs became visible on CT fluoroscopy after iodized-oil injection, and RF ablation was technically successful in all sessions (technical success rate, 100%, 90/90). Major complications occurred in 6 RF sessions (6.7%, 6/90), including hemorrhage (2.2%, 2/90), portal thrombosis (2.2%, 2/90), and pneumothorax (2.2%, 2/90). No significant deterioration in Child-Pugh score was found. The mean follow-up period was 23.2 ± 18.0 months. The cumulative local tumor progression rates and overall survival rates were, respectively, 3.9 and 82.7% at 1 year, 5.3 and 45.3% at 3 years, and 5.3 and 26.4% at 5 years.
CT fluoroscopy-guided RF ablation following intra-arterial iodized-oil injection is a feasible, safe, and useful therapeutic option for HCCs invisible on US images.
我们旨在评估经动脉碘化油注射后行射频（RF）消融治疗超声（US）图像不显影的肝细胞癌（HCC）的治疗效果。
本研究经机构审查委员会批准，为回顾性研究，豁免了患者知情同意。67 例连续患者的 150 个 HCC（平均直径 1.3±0.6cm；范围 0.5-4.2cm）在经动脉碘化油注射后接受了 90 次 RF 消融治疗。每个患者均至少有一个 HCC 在 US 图像上不显影。在注射碘化油后 1 周内行 CT 透视引导下 RF 消融治疗，从每个肿瘤的供血动脉注入碘油。技术成功定义为计划的电极放置和消融方案的完成。评估技术成功率、并发症、肝功能变化、局部肿瘤进展和生存情况。
所有 HCC 在经碘油注射后在 CT 透视下均可见，所有治疗均获得技术成功（技术成功率，100%，90/90）。6 次 RF 消融治疗（6.7%，6/90）出现主要并发症，包括出血（2.2%，2/90）、门静脉血栓形成（2.2%，2/90）和气胸（2.2%，2/90）。未发现 Child-Pugh 评分显著恶化。中位随访时间为 23.2±18.0 个月。1 年时的累积局部肿瘤进展率和总生存率分别为 3.9%和 82.7%，3 年时分别为 5.3%和 45.3%，5 年时分别为 5.3%和 26.4%。
经动脉碘化油注射后行 CT 透视引导 RF 消融治疗超声图像不显影的 HCC 是一种可行、安全且有效的治疗选择。
