Percutaneous Radiofrequency Ablation of Liver Tumors with the LeVeen Probe: Is Roll-off Predictive of Response?
2001; Elsevier BV; Volume: 12; Issue: 4 Linguagem: Inglês
10.1016/s1051-0443(07)61884-3
ISSN1535-7732
AutoresMichael Arata, Harvey Nisenbaum, Timothy W.I. Clark, Michael C. Soulen,
Tópico(s)Cholangiocarcinoma and Gallbladder Cancer Studies
ResumoThe LeVeen radiofrequency (RF) probe uses roll-off of electrical impedance as the endpoint for RF cautery of hepatic tumors. The purpose of this study is to determine the relation of roll-off to local control of hepatic tumors.Twenty hepatic tumors, including 10 hepatomas and 10 metastases, were treated. Lesions ranged from 1.4 cm to 6.0 cm in diameter; 13 (57%) were smaller than 3.0 cm. Each lesion was ablated with use of the LeVeen 15-gauge RF needle according to the manufacturer's protocol. Five patients underwent chemoembolization the day before. Patients were followed up with contrast-enhanced computed tomography or magnetic resonance imaging at 1 month and every 3 months thereafter.Among the 20 lesions, roll-off was achieved at all burn locations in 11 (55%), no burn locations in eight (40%), and two of three burn locations in one (5%). Roll-off was observed in all patients who had undergone chemoembolization the day before. Six local recurrences occurred, five after RF ablation without roll-off and one after RF ablation with roll-off. According to life-table analysis, the local recurrence rate at 6 months without roll-off was 43% and with roll-off was 15% (P =.024; OR = 8.3; 95% CI = 0.93-66).Roll-off is a significant predictor of local control after RF ablation. Strategies to enhance roll-off, such as concurrent embolization, may be important to optimize the therapeutic effect of this device.
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