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© 2002 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 21:67-76 • 0278-4297

Article

Small Hepatocellular Carcinoma

Therapeutic Effectiveness of Percutaneous Radio Frequency Ablation Therapy With a LeVeen Needle Electrode

Kazuhito Shirato, MD, Manabu Morimoto, MD, Naohiko Tomita, MD, Atsushi Kokawa, MD, Kazuya Sugimori, MD, Takafumi Saito, MD, Kazushi Numata, MD, Hisahiko Sekihara, MD and Katsuaki Tanaka, MD

Gastroenterological Center, Yokohama City University Medical Center (K.Sh., M.M., N.T., A.K., K.Su., T.S., K.T.), and Third Department of Internal Medicine, Yokohama City University School of Medicine (K.N., H.S.), Yokohama, Japan

Address correspondence and reprint requests to Kazuhito Shirato, MD, Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama 232-0024, Japan.

Objective. To evaluate the therapeutic effectiveness of percutaneous radio frequency ablation of small (<=3-cm) hepatocellular carcinoma with a LeVeen needle electrode. Methods. Thirty patients (mean age, 65.7 years) with 32 hepatocellular carcinomas (range, 1.2–3.0 cm; mean, 2.3 ± 0.5 cm) underwent percutaneous radio frequency ablation to the center of the hepatocellular carcinoma after expansion of the inner needles. The manufacturer's recommended radio frequency ablation protocol was used. Posttreatment contrast-enhanced color Doppler sonography, contrast-enhanced computed tomography, and fine-needle biopsy were performed to assess the radio frequency ablation–induced coagulated necrosis. Results. Severe intratreatment pain made us abort radio frequency ablation in 2 patients. Complete tumor necrosis was achieved in 1 treatment session with 1 needle electrode insertion in 28 (93.4 %) of 30 nodules (28 patients). We found no residual focus on both color Doppler sonography and computed tomography after any of the sessions. In follow-ups ranging from 3 to 15 months (mean, 8.4 months), no local recurrence was found in cases with complete tumor ablation. Conclusions. Radio frequency ablation with the LeVeen needle electrode was effective, obtaining complete coagulated necrosis with a safety margin when used for the treatment of small hepatocellular carcinomas.

Key Words: hepatocellular carcinoma • radio frequency ablation • LeVeen needle electrode

Abbreviations: AFP, {alpha}-fetoprotein • CDS, color Doppler sonography • CT, computed tomography • HCC, hepatocellular carcinoma • PEI, percutaneous ethanol injection • RF, radio frequency • RFA, radio frequency ablation • SAE, stimulated acoustic emission




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