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Percutaneous Sonographically Guided Saline-Enhanced Radiofrequency Ablation of Hepatocellular Carcinoma

¹ All authors: Interventional Ultrasound Service, D. Cotugno Hospital, Viale Colli Aminei 491, Naples 80131, Italy.

View larger version (140K): [in a new window]   Fig. 1A. —Photographs of radiofrequency generator (A) (Elektrotom 106, HITT, Berchtold, Germany) used for high frequency–induced thermotherapy treatment. On top of generator is peristaltic pump (arrow) for injection of saline solution through needle electrode.

View larger version (79K): [in a new window]   Fig. 1B. —Photographs of needle electrode (B) (Elektrotom 106, HITT, Berchtold, Germany) used for high frequency–induced thermotherapy treatment. Close-up shows exposed tip of needle electrode.

View larger version (160K): [in a new window]   Fig. 2A. —60-year-old woman with hepatocellular carcinoma and liver cirrhosis. Subcostal sonogram of liver reveals 3.5-cm-diameter hepatocellular carcinoma in segment V.

View larger version (143K): [in a new window]   Fig. 2B. —60-year-old woman with hepatocellular carcinoma and liver cirrhosis. Sonogram shows intensely hyperechoic exposed tip of electrode inserted into tumor.

View larger version (134K): [in a new window]   Fig. 2C. —60-year-old woman with hepatocellular carcinoma and liver cirrhosis. On sonogram obtained immediately after generator was switched on, hyperechoic area is seen forming around electrode.

View larger version (121K): [in a new window]   Fig. 2D. —60-year-old woman with hepatocellular carcinoma and liver cirrhosis. Sonogram shows progressive enlargement of hyperechoic area resulting from thermal effect.

View larger version (146K): [in a new window]   Fig. 2E. —60-year-old woman with hepatocellular carcinoma and liver cirrhosis. On sonogram obtained at end of 10-min treatment, lesion appears completely hyperechoic.

View larger version (115K): [in a new window]   Fig. 3A. —65-year-old man with hepatocellular carcinoma and liver cirrhosis. Sonogram shows first insertion of needle electrode (arrow) into large hepatocellular carcinoma of right hepatic lobe (between arrowheads). Multiple other electrode insertions were needed to treat areas of tumor that did not become hyperechogenic during ablation procedure (not shown).

View larger version (148K): [in a new window]   Fig. 2F. —60-year-old woman with hepatocellular carcinoma and liver cirrhosis. Helical CT scan obtained during arterial phase 4 weeks after treatment shows completely hypodense lesion. This posttreatment CT pattern indicates complete necrosis of tumor.

View larger version (140K): [in a new window]   Fig. 3B. —65-year-old man with hepatocellular carcinoma and liver cirrhosis. Helical arterial phase CT scan obtained 4 weeks after treatment shows necrosis of tumor with viable malignant area (arrow) along medial margin of lesion.

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