To know various technical tips to overcome limitations of percutaenous RFA of the hepatic tumorTo know various technical tips to avoid potential complications of percutaneous RFA of the liverTo demonstrate protocols of percutaneous RFA accumulated from over 3000 cases
Since we started RFA of the liver in 1999, we have performed over 3000 cases to treat hepatic malignancies. US-guided procedure has strength in terms of wide availability, high versatility, and no radiation hazard. However, it has drawbacks as well. It is infrequently difficult to detect the tumor which was obvious on CT/MR due to isoechogenicity or inborn limitation of sonic window as in hepatic dome. Moreover, percutaneous procedure itself has limitations such as risk of collateral thermal damages. To overcome drawbacks, several strategies could...
Imaging findings OR Procedure details
Routines of US-guided percutaneous RFA
Single tumor ≤5cm; multiple tumors≤3, ≤3cm
Child-Pugh class A or B
Platelet >50,000/mm3 Prothrombin time>50%
No portal venous thrombosis or extrahepatic metastasis
Planning US in outpatient
Routine lab exam (CBC, Liver function, coagulation, tumor marker)
Admission one day before RFA
Overnight fasting (> 6 hours)
Getting informed consent
IV conscious sedation (pethidine/fentanyl HCl), drip infusion
Real time vital sign monitoring §US-guided percutaneous RFA with free hand technique
IV atropine sulfate (PRN)
Immediate follow-up 3 phase-CT
Our technical tips could be valuable in achieving successful US-guided percutaneous RFA of the hepatic tumor especially for the beginner of this procedure.
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