Percutaneous Dual-Switching Monopolar Radiofrequency Ablation Using a Separable Clustered Electrode: A Preliminary Study

• Published in: Korean journal of radiology Vol. 18; no. 5; pp. 799 - 808
• Main Authors: Choi, Tae Won, Lee, Jeong Min, Lee, Dong Ho, Lee, Jeong-Hoon, Yu, Su Jong, Kim, Yoon Jun, Yoon, Jung-Hwan, Han, Joon Koo
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Radiology 01.09.2017; 대한영상의학회
• Subjects: Ablation; Aged; Carcinoma, Hepatocellular - mortality; Carcinoma, Hepatocellular - surgery; Catheter Ablation - adverse effects; Catheter Ablation - instrumentation; Catheter Ablation - methods; Electrodes; Energy; Female; Gastrointestinal Imaging; Humans; Liver cancer; Liver cirrhosis; Liver Neoplasms - mortality; Liver Neoplasms - surgery; Male; Middle Aged; Pericardial Effusion - etiology; Pleural Effusion - etiology; Retrospective Studies; Serum Albumin - analysis; Survival Rate; Tumors; Veins & arteries; 방사선과학; Radiofrequency ablation; Therapeutic efficacy; Hepatocellular carcinoma; Local ablation therapy; Liver
• ISSN: 1229-6929; 2005-8330; 2005-8330
• DOI: 10.3348/kjr.2017.18.5.799

To prospectively evaluate the safety and therapeutic effectiveness of dual-switching monopolar (DSM) radiofrequency ablation (RFA) for the treatment of hepatocellular carcinoma (HCC), and to retrospectively compare the results with those of single-switching monopolar (SSM) RFA in a historical control group. This study was approved by the Institutional Review Board, with informed consent obtained from all patients. Fifty-two HCC patients who underwent DSM-RFA using a separable clustered electrode and dual-generators were prospectively enrolled. Technical parameters, complications, technical success, technical effectiveness, and local tumor progression (LTP) rates were evaluated by means of post-procedural and follow-up imaging. Thereafter, the outcome of DSM-RFA was compared with those of 249 retrospectively included HCC patients treated with SSM-RFA. There were two major complications (3.8%, 2/52) including pleural and pericardial effusion in the DSM-RFA group. The DSM-RFA yielded a 100% technical success rate, a 98.1% technical effectiveness rate, and a 4.3% 2-year LTP rate. In a retrospective comparison between the two groups, DSM-RFA created significantly larger ablation volume (4.20 ± 2.07 cm /min vs. 3.03 ± 1.99 cm /min, < 0.01), and delivered higher energy (1.43 ± 0.37 kcal/min vs. 1.25 ± 0.50 kcal/min, < 0.01) per given time, than SSM-RFA. There was no significant difference in major procedure-related complications (3.8% vs. 4.4%) and technical effectiveness rate (98.1% vs. 96.4%) between the two groups ( = 1.00). In addition, the 2-year LTP rate of DSM-RFA and SSM-RFA were 4.3% and 10.1%, respectively ( = 0.15). DSM-RFA using a separable clustered electrode is safe and provides high local tumor control and good preliminary clinical outcome for small HCCs, which are at least comparable to those of SSM-RFA.