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Purposes: This study aimed to investigate the efficacy of ultrasound (US)-, computed tomography (CT)-, and magnetic resonance imaging (MRI)-guided radiofrequency ablation (RFA) for the treatment of hepatocellular carcinoma (HCC). Materials and Methods: This retrospective study included 141 patients with HCC who were treated with US-guided (n = 29), CT-guided (n = 50), or MRI-guided RFA (n = 62). The primary endpoint was progression-free survival (PFS). The secondary endpoints included overall survival (OS), technique success (TS), and technique efficacy (TE). Cox model and logistic regression were used to determine the risk factors for tumor recurrence and TE. Results: The US, CT, and MRI groups did not show a significant difference in terms of baseline variables. The three groups did not differ significantly in PFS rate (P = 0.072) and OS rate (P = 0.231). The PFS rates at 3 years for the US, CT, and MRI groups were 40.90%, not reached, and 14.80%, respectively. The OS rates at 3 years were 94.70%, 97.50%, and 85.50% for US, CT, and MRI groups, respectively. No significant differences were observed between the three groups in terms of TS rate (P = 0.113) and TE rate (P = 0.682). In multivariate analysis, liver cirrhosis (P = 0.001), level of alpha-fetoprotein (AFP, P = 0.004), and number of tumors (P = 0.012) were independent risk factors for PFS. For TE, the level of AFP (P = 0.018) was an independent factor. Conclusion: US-, CT-, and MRI-guided RFA was effective for treating HCC patients. Liver cirrhosis, AFP level, and tumor number were associated with tumor recurrence, and the level of AFP was an independent risk factor affecting TE
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Objective To evaluate the efficacy and safety of transcatheter hepatic arterial chemoembolization (TACE) combined with CT guided radiofrequency ablation (RFA) for primary liver cancer in the caudate lobe.Methods Sixteen patients with primary liver cancer in the caudate lobe were treated with combination therapy of TACE and RFA.Complet ablation rate,overall and recurrence-free survival,and complications were evaluated.Results A total of 15 cases achieved complet ablation,complet ablation rate was 93.75％ (15/16).Recurrence-free survival time was 19.35 months,overall survival time was 44.62 months.Overall survival rates were 88.23％,66.65％ and 33.18％ at 1,3,5 years after therapy,respectively.Conclusion TACE combined with RFA is a safe and useful therapeutic option for treatment of primary liver cancer in the caudate lobe.
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Objective To investigate the efficacy and safety of transcatheter arterial chemoembolization (TACE) combined with CT-guided thermal ablation (radiofrequency ablation or microwave ablation) in treating intrahepatic cholangiocarcinoma.Methods The clinical data of 14 patients with pathologicallyproved intrahepatic cholangiocarcinoma,who were admitted to authors' hospital during the period from September 2009 to July 2013 to receive TACE with subsequent radiofrequency ablation (RFA) or microwave ablation (MWA),were retrospectively analyzed.A total of 18 lesions were detected in the 14 patients.The maximal diameter of the lesion (or the sum of maximal diameters if there were multiple lesions) ranged from 2.2 cm to 7.2 cm (mean 4.2±1.4 cm).After TACE,the lesion's complete ablation rate,surgical complications,tumor-free survival time and overall survival time were evaluated.Results Complete ablation was obtained in 15 lesions (83.3％,15/18).The incidence of moderate complications was 6.2％,and no severe complications or death occurred.After the treatment,the patients were followed up for 6-14 months,with a mean of (16.0±10.3) months.At the end of follow-up,6 patients (42.9％,6/14) died.The median tumor-free survival time in patients whose lesions obtained complete ablation was 17 months.The median survival time of all patients was 20 months.The 1-,2-and 3-year overall survival rates were 82.5％,41.3％ and 20.6％ respectively.Conclusion TACE combined with thermal ablation can be regarded as one of the treatment options for intrahepatic cholangiocarcinoma.
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Objective To evaluate the therapeutic effectiveness of treating adrenal gland neoplasms by CT-guided absolute alcohol injection. Methods Eleven patients with adrenal gland neoplasms were examined by CT to identify the lesion′s size, location, and the relationship with its surrounding tissue. The needling direction was first chosen, and the syringe needle was placed at the center of tumor or the destined position. Absolute ethyl alcohol was injected after rescanning to confirm the position of syringe needle was inerrant. The blood sugar and blood pressure were checked before operation. After operation, analysis of the clinical manifestations was performed and the blood sugar and blood pressure were measured at once, 24 h, 48 h, one week, one month, and two months, respectively. To observe the absorption of the lesions, postoperative follow-up CT scans were performed at one month and later on. Results Significant differences in blood pressures and blood sugar were observed between preoperation and 24 hours after the operation (P
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Objective To evaluate the safe ty and efficacy of CT-guided percuta neous ethanol injection (CT-PEI) in the treatment of thyroid adenoma. M ethods Fifty-four patients with 73 nodules were included in the study. Thyroi d adenoma was confirmed by pathology. The serum level T3, T4, and TSH were norma l in all cases. CT-PEI (0.3-2.5 ml ethanol/cm~3 nodular tissue) was given for 115 times (mean 1.58?078 times/nodule). Results Complete cu re was observed in 37 nodules (50.7%). In 28 nodules (38.3%) volume reduction was greater than 80%. A significant nodule reduction (50%-80%) was observed in 7 nodules. Only 1 (1. 4%) nodule volume reduction was 28.9%. Apart from 1 case of transient dysphonia and 2 cases of mild pain and burning sensation, no side effect was observed. Conclusion CT-PEI is a safe and effective therapeutic procedure with f ew side effects for thyroid adenoma.
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Objective To evaluate the efficacy of emergency transcatheter arterial embolization(TAE)for spontaneous rupture of hepatocellular carcinoma(HCC).Methods We retrospectively reviewed 16 cases of spontaneous ruptured HCC which had been treated in our hospital between 1997 and 2005.Emergency TAE was performed in the 16 patients,with 6 cases complicated by hypovolemic.Results Bleeding from the ruptured HCC was stopped at the end of the procedure in 16 patients who had undergone successful embolization.The time from the onset of clinical symprtom to TAE been completed was 1.5-5 hours(mean,3.6 hours),The shortest time was 1.5 hours in 3 patients.Following the achievement of hemostasis by TAE,transcatheter arterial chemoembolization(TACE)2-6 times for each case with average 3.7 and CT guided percutaneous ethanol injection(CT-PEI)5-9 times for every case with arerage 6.8 were performed in 12 cases.3 cases were given up for further treatment.The liver transplantation was carried out in 1 case 3 days after TAE.The average survival time was 14.3 months.Conclusions Emergency TAE is safe and effective for bleeding due to spontaneous rupture in HCC and would achieve better result by adding TACE and CT-PEI.Liver transplantation is one of the options for the patients with poor liver function.The combination of all methods above can prolong patients survival time.(J Intervent Radiol,2006,15:228-231)