2011•The Egyptian Journal of Radiology and Nuclear MedicineOpen access

Ultrasound-guided microwave ablation of hepatocellular carcinoma: Initial institutional experience

Osama Mohamed Abdelhamid Hetta, Naglaa Hussein Shebrya, Sherine Kadry Amin

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Abstract

Microwave ablation (MWA) is a new treatment modality for hepatocellular carcinoma (HCC) at our institution. The aim of this study is to evaluate the safety, procedure time and rate of complete ablation of this new modality. Hospital medical ethics committee approval and informed consent were obtained. A total of 98 nodules in 72 patients (59 male, 13 female; mean age 57 (±4.6) years, range 50–70 years) with HCC were treated with microwave ablation at our institution from June 2010 to February 2011. A 14 G cooled shaft Amica probe was introduced into the tumors under analgesic sedation and by US guidance. The patients were then followed up with contrast enhanced computed tomography (CT) and serum α-fetoprotein levels. One month after therapy, complete ablation was obtained in 96% (94/98) nodules. The complete ablation rate in tumors ⩽3 cm and those >3 cm were 98%, and 94%, respectively. MW ablation success was higher with nodules ⩽3 cm (57/58, 98.3%) in comparison to nodules >3 cm (37/40, 92.5%): however, the difference was non-significant (P = 0.301). No complication occurred related to the ablation procedure, only minor complications post-ablation, as pain in (3/72) patients, mild fever in (48/72) patients, and discharge from wound in (2/72) patients. No local recurrence was detected, however, new lesions at other sites of the liver occurred in 11 (15%) patients. Sonographically guided percutaneous microwave ablation proved to be safe, fast, and effective for treatment of hepatocellular carcinoma.

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What this paper is about

Microwave ablation (MWA) is a new treatment modality for hepatocellular carcinoma (HCC) at our institution. The aim of this study is to evaluate the safety, procedure time and rate of complete ablation of this new modality. Hospital medical ethics committee approval and informed consent were obtained. A total of 98 nodules in 72 patients (59 male, 13 female; mean age 57 (±4.6) years, range 50–70 years) with HCC were treated with microwave ablation at our institution from June 2010 to February 2011. A 14 G cooled shaft Amica probe was introduced into the tumors under analgesic sedation and by US guidance. The patients were then followed up with contrast enhanced computed tomography (CT) and serum α-fetoprotein levels. One month after therapy, complete ablation was obtained in 96% (94/98) nodules. The complete ablation rate in tumors ⩽3 cm and those >3 cm were 98%, and 94%, respectively. MW ablation success was higher with nodules ⩽3 cm (57/58, 98.3%) in comparison to nodules >3 cm (37/40, 92.5%): however, the difference was non-significant (P = 0.301). No complication occurred related to the ablation procedure, only minor complications post-ablation, as pain in (3/72) patients, mild fever in (48/72) patients, and discharge from wound in (2/72) patients. No local recurrence was detected, however, new lesions at other sites of the liver occurred in 11 (15%) patients. Sonographically guided percutaneous microwave ablation proved to be safe, fast, and effective for treatment of hepatocellular carcinoma.

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Available abstract

Microwave ablation (MWA) is a new treatment modality for hepatocellular carcinoma (HCC) at our institution. The aim of this study is to evaluate the safety, procedure time and rate of complete ablation of this new modality. Hospital medical ethics committee approval and informed consent were obtained. A total of 98 nodules in 72 patients (59 male, 13 female; mean age 57 (±4.6) years, range 50–70 years) with HCC were treated with microwave ablation at our institution from June 2010 to February 2011. A 14 G cooled shaft Amica probe was introduced into the tumors under analgesic sedation and by US guidance. The patients were then followed up with contrast enhanced computed tomography (CT) and serum α-fetoprotein levels. One month after therapy, complete ablation was obtained in 96% (94/98) nodules. The complete ablation rate in tumors ⩽3 cm and those >3 cm were 98%, and 94%, respectively. MW ablation success was higher with nodules ⩽3 cm (57/58, 98.3%) in comparison to nodules >3 cm (37/40, 92.5%): however, the difference was non-significant (P = 0.301). No complication occurred related to the ablation procedure, only minor complications post-ablation, as pain in (3/72) patients, mild fever in (48/72) patients, and discharge from wound in (2/72) patients. No local recurrence was detected, however, new lesions at other sites of the liver occurred in 11 (15%) patients. Sonographically guided percutaneous microwave ablation proved to be safe, fast, and effective for treatment of hepatocellular carcinoma.

Key concepts: Medicine, Microwave ablation, Hepatocellular carcinoma, Ablation, Percutaneous, Ablation zone, Radiology, Complication

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