Radiofrequency ablation of hepatic tumors: Variability of lesion size using a single ablation device

被引:72
作者
Montgomery, RS [1 ]
Rahal, A [1 ]
Dodd, GD [1 ]
Leyendecker, JR [1 ]
Hubbard, LG [1 ]
机构
[1] Univ Texas, Hlth Sci Ctr, Dept Radiol, Sch Med, San Antonio, TX 78229 USA
关键词
D O I
10.2214/ajr.182.3.1820657
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
OBJECTIVE. In this study, we examined the variability of lesion sizes produced by a single radiofrequency ablation using the same device and algorithm in patients with small malignant hepatic tumors. MATERIALS AND METHODS. A review of the clinical records of 208 patients who underwent radiofrequency ablation of malignant hepatic tumors during a 6-year period revealed 31 patients with small tumors that were treated with a single ablation. Clinical data were recorded using standardized work sheets. Tumor and lesion sizes after ablation were measured from CT scans. The influences of tumor size, tumor type, presence or absence of cirrhosis, and tissue temperature on the ablation size were analyzed. RESULTS. The size of tumor before treatment ranged from 0.8 to 4.0 cm (mean diameter [+/- SD] = 1.8 +/- 0.9 cm) with corresponding volumes of 0.27-30.24 mL (mean volume = 27.1 +/- 15.9 mL). The lesion sizes after ablation ranged from 1.7 to 5.3 cm (mean diameter = 3.6 +/- 0.7 cm) with corresponding volumes of 2.29-75.87 mL (mean volume = 4.9 +/- 7.1 mL). Tumor type (p > 0.25), presence or absence of cirrhosis (p > 0.45), and tissue temperature (p = 0.055) had no relationship to ablation size. Tumor size had a statistically significant influence on ablation lesion size (p < 0.04). Ablation of small tumors (diameter less than or equal to 2.25 cm, n = 32) produced random lesion sizes whereas ablation of large tumors (diameter > 2.25 cm, n = 11) produced larger lesions (mean diameter = 4.0 +/- 0.8 cm). CONCLUSION. Significant variation occurs in the lesion size produced using the same ablation device and algorithm. These findings must be considered when planning ablation strategies.
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收藏
页码:657 / 661
页数:5
相关论文
共 12 条
[1]   Surgical margin in hepatic resection for colorectal metastasis - A critical and improvable determinant of outcome [J].
Cady, B ;
Jenkins, RL ;
Steele, GD ;
Lewis, WD ;
Stone, MD ;
McDermott, WV ;
Jessup, JM ;
Bothe, A ;
Lalor, P ;
Lovett, EJ ;
Lavin, P ;
Linehan, DC .
ANNALS OF SURGERY, 1998, 227 (04) :566-571
[2]   Radiofrequency thermal ablation: Computer analysis of the size of the thermal injury created by overlapping ablations [J].
Dodd, GD ;
Frank, MS ;
Aribandi, M ;
Chopra, S ;
Chintapalli, KN .
AMERICAN JOURNAL OF ROENTGENOLOGY, 2001, 177 (04) :777-782
[3]   Minimally invasive treatment of malignant hepatic tumors: At the threshold of a major breakthrough [J].
Dodd, GD ;
Soulen, MC ;
Kane, RA ;
Livraghi, T ;
Lees, WR ;
Yamashita, Y ;
Gillams, AR ;
Karahan, OI ;
Rhim, H .
RADIOGRAPHICS, 2000, 20 (01) :9-27
[4]   Resection of liver metastases from colorectal cancer: the real impact of the surgical margin [J].
Elias, D ;
Cavalcanti, A ;
Sabourin, JC ;
Lassau, N ;
Pignon, JP ;
Ducreux, M ;
Coyle, C ;
Lasser, P .
EUROPEAN JOURNAL OF SURGICAL ONCOLOGY, 1998, 24 (03) :174-179
[5]   Tumor ablation with radio-frequency energy [J].
Gazelle, GS ;
Goldberg, SN ;
Solbiati, L ;
Livraghi, T .
RADIOLOGY, 2000, 217 (03) :633-646
[6]   Large-volume tissue ablation with radio frequency by using a clustered, internally cooled electrode technique: Laboratory and clinical experience in liver metastases [J].
Goldberg, SN ;
Solbiati, L ;
Hahn, PF ;
Cosman, E ;
Conrad, JE ;
Fogle, R ;
Gazelle, GS .
RADIOLOGY, 1998, 209 (02) :371-379
[7]   Percutaneous radiofrequency tissue ablation: Does perfusion-mediated tissue cooling limit coagulation necrosis? [J].
Goldberg, SN ;
Hahn, PF ;
Tanabe, KK ;
Mueller, PR ;
Schima, W ;
Athanasoulis, CA ;
Compton, CC ;
Solbiati, L ;
Gazelle, GS .
JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 1998, 9 (01) :101-111
[8]   Thermal ablation therapy for focal malignancy: A unified approach to underlying principles, techniques, and diagnostic imaging guidance [J].
Goldberg, SN ;
Gazelle, GS ;
Mueller, PR .
AMERICAN JOURNAL OF ROENTGENOLOGY, 2000, 174 (02) :323-331
[9]   Radiofrequency ablation of the liver: Current status [J].
McGahan, JP ;
Dodd, GD .
AMERICAN JOURNAL OF ROENTGENOLOGY, 2001, 176 (01) :3-16
[10]   Laparoscopic radiofrequency ablation of the liver in proximity to major vasculature: Effect of the Pringle maneuver [J].
Shen, P ;
Fleming, S ;
Westcott, C ;
Challa, V .
JOURNAL OF SURGICAL ONCOLOGY, 2003, 83 (01) :36-41