Abstract
Purpose
To evaluate technique effectiveness, safety, and interoperator performance of stereotactic radiofrequency ablation (SRFA) of liver lesions.
Methods
Retrospective review including 90 consecutive patients from January 2008 to January 2010 with 106 computed tomography-guided SRFA sessions using both single and multiple electrodes for the treatment of 177 lesions: 72 hepatocellular carcinoma (HCC) and 105 metastases with a mean size of 2.9 cm (range 0.5–11 cm). Technique effectiveness and 1-year local recurrence were evaluated by computed tomographic scans. Complications, mortality, and hospital days were recorded. The performance between an experienced and inexperienced interventional radiologist was compared.
Results
The overall technique effectiveness after a single SRFA was 95.5% (93.1% for HCC and 97.1% for metastases). Four of the eight unsuccessfully treated lesions could be retreated (secondary technique effectiveness of 97.7%). Local recurrence at 1 year was 2.9%. Technique effectiveness was significantly different for lesions <5 cm (96.7%) and >5 cm (87.5%) (P = 0.044) but not for lesions <3 cm (95.9%) and 3–5 cm (100%). Compared to clear parenchymal property (97.3%), vessel vicinity (93.3%) (P = 0.349) and subcapsular (95.2%) (P = 0.532) had no, but hollow viscera vicinity (83.3%) had a significantly lower technique effectiveness (P = 0.020). Mortality rate was 0.9%. Major complications and hospital days were higher for cirrhosis Child-Pugh B (20%, 7.2 days) than Child-Pugh A (3.1%, 4.7 days) patients and for metastases (5.1%, 4.3 days). There was no significant difference in interoperator performance.
Conclusion
SRFA allowed for efficient, reliable, and safe ablation of large-volume liver disease.
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Acknowledgments
The authors thank the radiation technicians: Bob Lang, RT, Martin Fasser, RT, Martin Knoflach, RT, Julia Mahlknecht, RT, and Florian Schanda, RT.
Conflict of interest
Gerlig Widmann, Peter Schullian, and Marion Haidu have no conflict of interest. Reto Bale is a coinventor of the stereotactic aiming device used in this study (Atlas, Medical Intelligence GesmbH, Schwabmünchen, Germany) and a coshareholder in its financial returns.
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Widmann, G., Schullian, P., Haidu, M. et al. Stereotactic Radiofrequency Ablation (SRFA) of Liver Lesions: Technique Effectiveness, Safety, and Interoperator Performance. Cardiovasc Intervent Radiol 35, 570–580 (2012). https://doi.org/10.1007/s00270-011-0200-4
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DOI: https://doi.org/10.1007/s00270-011-0200-4