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Combined Radiofrequency and Alcohol Injection for Percutaneous Hepatic Tumor Ablation

Sridhar Shankar1,2,3, Eric vanSonnenberg2,3, Paul R. Morrison3, Kemal Tuncali3 and Stuart G. Silverman3

1 Department of Radiology, University of Massachusetts, 55 Lake Ave. N, Worcester, MA 01655.
2 Department of Radiology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA 02115.
3 Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115.



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  		Fig. 1A. —88-year-old woman with solitary 5.5-cm colon cancer metastasis in liver. T1-weighted contrast-enhanced axial MR image shows rim-enhancing mass in right lobe of liver.

 


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  		Fig. 1B. —88-year-old woman with solitary 5.5-cm colon cancer metastasis in liver. Intraprocedural unenhanced CT scan shows radiofrequency probe within lesion. Three radiofrequency applications were performed.

 


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  		Fig. 1C. —88-year-old woman with solitary 5.5-cm colon cancer metastasis in liver. Contrast-enhanced MR image obtained after radiofrequency ablation shows necrosis as nonenhancing area measuring 71.5 cm2.

 


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  		Fig. 2A. —40-year-old woman with colon cancer metastatic to liver. T1-weighted contrast-enhanced axial MR image shows large mass in inferior right lobe of liver, measuring 9.5 cm in longest axis.

 


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  		Fig. 2B. —40-year-old woman with colon cancer metastatic to liver. Intraprocedural unenhanced CT scan shows alcohol injection within tumor; 10 mL of alcohol was injected.

 


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  		Fig. 2C. —40-year-old woman with colon cancer metastatic to liver. Intraprocedural CT scan shows radiofrequency ablation in progress; two radiofrequency applications were performed. Note relatively large amount of gas around probe.

 


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  		Fig. 2D. —40-year-old woman with colon cancer metastatic to liver. T1-weighted contrast-enhanced MR image obtained after procedure shows large area of necrosis; 249 cm2 of necrosis was obtained with two radiofrequency applications.

 

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