Purpose
The percutaneous ultrasound-guided and -monitored (USGM) radiofrequency ablation (RFA) is a widely implicated local therapy for liver tumours. Other RFA approaches (laparoscopic and open) are not as popular as the percutaneuous one. The influence of the tumour localization within liver on the percutaneous RFA efficiency is studied in the paper.
Material and methods
Since January 2003 39 patients underwent 77 (range 1-8) percutaneous USGM RFA of 101 primary and secondary liver tumours (Radionic Cool-tip RF System). The completeness of RFA was evaluated using T2 STIR, T2 TSE and contrast enhanced T1 magnetic resonance images (MRI) at the first post-procedural day. Additional RFA procedures were performed when residual neoplastic tissue had been revealed.
Results
The primary (number of complete necroses after first RFA attempt/ number of lesions) and the total (number of complete necroses after all RFA attempts/ number of lesions) RFA efficiency rates were estimated. They were following: 1st segment - 0/2 and 2/2, 2nd segment - 45.5% (5/11) and 54.5% (6/11), 3rd segment - 91.7% (11/12) and 100.0 % (12/12), 4th segment - 78.4% (11/14) and 54.5% (12/14), 5th segment - 57.6% (11/19) and 100.0% (19/19), 6th segment - 40.0% (4/10) and 70.0% (7/10), 7th segment - 57.1% (8/14) and 92.9% (13/14), 8th segment - 50.0% (10/20) and 65.2% (13/20), total liver - 59.4% (60/101) and 83.2 (84/101). So, the 3rd and the 5th liver segments demonstrated the better efficiency rates while the 2nd and the 8th segments showed the worst ones.
Conclusion
The tumours within the 2rd and the 8th liver segments are weakly assessable for multipositional imaging and located close to the air-bearing organs (the gastric air bubble and the lung), which worsens the percutaneous USGM RFA conditions and often requires additional procedures. Under some circumstances, open or laparoscopic approaches may be useful for these tumour localizations.