RFA for Liver Tumor Unable to Image by US

  • Dr Koji Suto, Department of gastroenterology and Hepatology, Hirosaki City HospitaDepartment of gastroenterology and Hepatology, Hirosaki Ci, Japan
  • Dr Takenori Takahata, First Department of Internal medicine, Hirosaki Hirosaki university School of Medicine, Japan
  • Mr Naoya Sawada, First Department of Internal medicine, Hirosaki Hirosaki university School of Medicine, Japan
  • Dr, Hiroshi Tohno, Department of gastroenterology and Hepatology, Hirosaki City Hospital, Japan
  • Dr Masakatu Matukawa, Department of gastroenterology and Hepatology, Hirosaki City Hospital, Japan
  • Dr Tetsu Endo, First Department of Internal medicine, Hirosaki Hirosaki university School of Medicine, Japan
  • Dr Juichi Sakamoto, First Department of Internal medicine, Hirosaki Hirosaki university School of Medicine, Japan
  • Dr Shinsaku Fukuda, First Department of Internal medicine, Hirosaki Hirosaki university School of Medicine, Japan

    • Background: In Percutaneous radio frequency ablation therapy (RFA) for Liver tumor, imaging of target by Sonography (US) is necessary. However, the targets unable to image by US(UIT) is present. However hard it may be, correct hit with a RFA needle for such target is necessary .
    Objective: From September 1999 to December 2008, RFA treatment was performed for 541 patients (731 nodules) in our institute. In these, UIT was 15 cases (19 nodules). In the UIT, two cases (2 nodules) were onset lesions, and 13 cases(17 nodules) were recurrence lesions. All cases were hepatocellular carcinoma. For these 19 nodules, this method were performed.
    Method: In vicinity of region expected that target was present, fine needle (21 gauge) was punctured and placed under US guidance. And then, dynamic computed tomography (DCT) was performed. If fine needle was extremely away from target, one more fine needle was punctured and placed. In doing it this way, positional deviation between fine needle and target can be detected, and location of the target can be identified by US. By these method, we can hit the UIT with a RFA needle.
    Result: In an institution without special navigation system, this method is effective and available for the UIT. If it is a small lesion, ablation area can be evaluated by DCT on site.