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Percutaneous radiofrequency ablation for hepatic metastasis of colorectal cancer: assessment of tumor visibility and the feasibility of the procedure with planning ultrasonography

Ultrasonography 2022년 41권 1호 p.189 ~ 197
배정우, 이민우, 강태욱, 송경두, 차동익, 민지혜, 임현철,
소속 상세정보
배정우 ( Bae Jeong-Woo ) - Sungkyunkwan University School of Medicine
이민우 ( Lee Min-Woo ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiology
강태욱 ( Kang Tae-Wook ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiology
송경두 ( Song Kyoung-Doo ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiology
차동익 ( Cha Dong-Ik ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiology
민지혜 ( Min Ji-Hye ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiology
임현철 ( Rhim Hyun-Chul ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiology

Abstract


Purpose: The aim of this study was to assess the incidence and causes of percutaneous radiofrequency ablation (RFA) infeasibility in cases of metastatic colorectal cancer and to evaluate factors affecting the invisibility of the tumor on planning ultrasonography (US).

Methods: This study screened 386 patients who underwent planning US using fusion imaging and/or contrast-enhanced US for percutaneous RFA for suspected metastatic colorectal cancer between January 2013 and December 2020, from whom 136 patients with a single hepatic metastasis from colorectal cancer measuring <3 cm were included. The factors related to the infeasibility of percutaneous RFA were investigated. Univariate and multivariate analyses were performed to assess the factors associated with tumor invisibility on planning US.

Results: Among the 136 patients, percutaneous RFA was considered infeasible in 24.3% (33/136) due to a high risk of the heat-sink effect caused by the abutment of a large vessel (n=12), an inconspicuous tumor on planning US (n=11), a high risk of collateral thermal damage to an adjacent organ (n=8), and the absence of a safe electrode path (n=2). In univariate and multivariate analyses, tumor size was a statistically significant factor affecting invisibility on planning US (P=0.003 and P=0.018, respectively).

Conclusion: Percutaneous RFA was infeasible in approximately one-fourth of patients with metastatic colorectal cancer. The reason for the infeasibility was mainly an unfavorable tumor location and invisibility on planning US. Small tumor size was the sole significant factor affecting the invisibility of hepatic metastases on planning US.

키워드

Radiofrequency ablation; Metastasis; Liver; Planning ultrasonography; Detection

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