Aims and objectives
During last 15 yrs therapeutic approach to primary & metastatic disease has changed and improved.Besides surgical hepatic resection newer less invasive non surgical options are:
a)Chemical Ablation-Percutaneous Ethanol Injection (PEI)
b)Thermal Ablation-Radofrequency ablation (RFA) orMicrowave ablation RFA has particularly gained importance over a period of time even though there are definite known pros and cons of the procedure.Using appropriate selection and exclusion criterias the overall...
Methods and materials
Nine consecutive liver lesions; four metastatic and five primary HCC were considered suitable for US guided radiofrequency ablation with earlier CECT or PET CT or contrast MRI.
Total 4 metastatic lesions; one from breast and three from colonic primary are included in this study (Fig 12) .The size of these lesions was from 1.3cm to 4.7 cm located in various segments exceptcaudate lobe.Using additional tools of CEUS or fusion imaging the pre,
intra and immediate post RFA response was correctly...
Except in two cases all other lesions were considered ascompletely ablated based on pre and post CEUS enhancement pattern.
One metastatic lesion showed definite peripheral enhancement and was ablated in additional sitting within 3 hours (as shown in case 5-figure 11).
In other case CEUS showed minimal doubtful enhancement which on follow up PET imaging was reported as post RFA inflammatory response showing reducing SUV (standardized uptake values) on subsequent scan with no further abnormal...
Ultrasoundguidance is at times handicapped partly by lack of confident identification of lesionduringablation otherwise well seen on cross sectional imaging modalities and partly by deciding the end point ofablation merely on US due to difficulty in incorporating immediate timeconsuming post ablation PET or CECT.
Thisconfusioncan be minimisedusingreal-time con trast US & fusion imaging Contrast harmonic sonography guided RFA has better ablation rate after a single treatment session. Fusion...
Shenaz Momin M.D.,D.M.R.E. Additional Professor, Radiology Dept. Nair Hospital, Mumbai 400008 India firstname.lastname@example.org Dr.
Imaging Prince Aly Khan Hospital,Mumbai 400010 India. email@example.com
Hyunchul Rhim and Hyo K.
Radiofrequency Ablation of Hepatocellular Carcinoma: Pros and Cons,
Gut and Liver,
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2009 Bruix J,
Practice Guidelines Committee,
American Association for the study of Liver Diseases.
Management of hepatcellular carcinoma.
Hepatology 2005;42:1208-36 Wen YL,
Radiofrequency ablation of hepatocellular carcinoma.