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Semin intervent Radiol 2003; 20(4): 279-292
DOI: 10.1055/s-2004-828939
Copyright © 2003 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Radiofrequency Ablation of Hepatic Tumors

Kshitij A. Dalal, Damian E. Dupuy2 , S. Nahum Goldberg1
  • 1Minimally Invasive Tumor Therapy Laboratory, Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
  • 2Rhode Island Hospital, Brown Medical School, Providence, Rhode Island
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Publication History

Publication Date:
20 July 2004 (online)

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ABSTRACT

Minimally invasive image-guided procedures such as radiofrequency (RF) ablation, high intensity ultrasonography and microwave, as well as injectable therapies such as ethanol are becoming ever more useful options for the treatment of liver tumors. In this review, we focus initially on current clinical practice and research on radiofrequency ablation for both primary hepatocellular carcinoma and hepatic metastases from colon, breast, and neuroendocrine tumors. We then examine various treatment approaches such as laparoscopy and laparotomy, as well as the use of adjuvant therapies and imaging guidance. Finally, complications and current limitations of therapy are discussed.

KEYWORDS

Tumor ablation - radiofrequency - ablation - hepatic tumors

REFERENCES

  • 1 Goldberg S N, Liveraghi T, Solbiati L, Gazelle G S. In situ ablation of focal hepatic neoplasms. In: Gazelle GS, Saini S, Mueller PR, eds. Hepatobiliary and Pancreatic Radiology: Imaging and Intervention New York: Thieme, 1997: 470-502
    Google Scholar
  • 2 Dupuy D E, Goldberg S N. Image-guided radiofrequency tumor ablation: challenges and opportunities-part II.  J Vasc Interv Radiol . 2001;  12 1135-1148
    CrossrefPubMedGoogle Scholar
  • 3 Goldberg S N, Dupuy D E. Image-guided radiofrequency tumor ablation: Challenges and opportunities-Part I.  J Vasc Interv Radiol . 2001;  12 1021-1032
    PubMedGoogle Scholar
  • 4 Asahara T, Nakahara H, Fukuda T. et al . Percutaneous microwave coagulation therapy for hepatocellular carcinoma.  Hiroshima J Med Sci . 1998;  47 151-155
    PubMedGoogle Scholar
  • 5 Buscarini L, Buscarini E, Di Stasi M, Vallisa D, Quaretti P, Rocca A. Percutaneous radiofrequency ablation of small hepatocellular carcinoma: long-term results.  Eur Radiol . 2001;  11 914-921
    CrossrefPubMedGoogle Scholar
  • 6 Curley S A, Izzo F, Ellis L M, Nicolas Vauthey J, Vallone P. Radiofrequency ablation of hepatocellular cancer in 110 patients with cirrhosis.  Ann Surg . 2000;  232 381-391
    CrossrefPubMedGoogle Scholar
  • 7 Lu M D, Chen J W, Xie X Y. et al . Hepatocellular carcinoma: US-guided percutaneous microwave coagulation therapy.  Radiology . 2001;  221 167-172
    CrossrefPubMedGoogle Scholar
  • 8 Solbiati L, Ierace T, Tonolini M, Osti V, Cova L. Radiofrequency thermal ablation of hepatic metastases.  Eur J Ultrasound . 2001;  13 149-158
    CrossrefPubMedGoogle Scholar
  • 9 Gillams A R, Lees W R. Survival after percutaneous, image-guided, thermal ablation of hepatic metastases from colorectal cancer.  Dis Colon Rectum . 2000;  43 656-661
    CrossrefPubMedGoogle Scholar
  • 10 Shibata T, Niinobu T, Ogata N, Takami M. Microwave coagulation therapy for multiple hepatic metastases from colorectal carcinoma.  Cancer . 2000;  89 276-284
    CrossrefPubMedGoogle Scholar
  • 11 Beppu T, Doi K, Ishiko T, Hirota M, Egami H, Ogawa M. Efficacy of local ablation therapy for liver metastasis from colorectal cancer-radiofrequency ablation and microwave coagulation therapy.  Nippon Geka Gakkai Zasshi . 2001;  102 390-397
    PubMedGoogle Scholar
  • 12 Vogl T, Mack M, Straub R. et al . Thermal ablation of liver metastases. Current status and prospects.  Radiologe . 2001;  41 49-55
    CrossrefPubMedGoogle Scholar
  • 13 Mack M G, Straub R, Eichler K. et al . Percutaneous MR imaging-guided laser-induced thermotherapy of hepatic metastases.  Abdom Imaging . 2001;  26 369-374
    CrossrefPubMedGoogle Scholar
  • 14 Zagoria R J, Chen M Y, Kavanagh P V, Torti F M. Radio frequency ablation of lung metastases from renal cell carcinoma.  J Urol . 2001;  166 1827-1828
    PubMedGoogle Scholar
  • 15 Kim T S, Lim H K, Lee K S. et al . Imaging-guided percutaneous radiofrequency ablation of pulmonary metastatic nodules caused by hepatocellular carcinoma: preliminary experience.  AJR Am J Roentgol . 2003;  181 491-494
    PubMedGoogle Scholar
  • 16 Pautler S E, Pavlovich C P, Mikityansky I. et al . Retroperitoneoscopic-guided radiofrequency ablation of renal tumors.  Can J Urol . 2001;  8 1330-1333
    PubMedGoogle Scholar
  • 17 Pavlovich C P, Walther M M, Choyke P L. et al . Percutaneous radio frequency ablation of small renal tumors: initial results.  J Urol . 2002;  167 10-15
    CrossrefPubMedGoogle Scholar
  • 18 Murphy D P, Gill I S. Energy-based renal tumor ablation: a review.  Semin Urol Oncol . 2001;  19 133-140
    PubMedGoogle Scholar
  • 19 Dupuy D E, Monchik J M, Decrea C, Pisharodi L. Radiofrequency ablation of regional recurrence from well-differentiated thyroid malignancy.  Surgery . 2001;  130 971-977
    CrossrefPubMedGoogle Scholar
  • 20 Jeffery S S, Birdwell R L, Ikeda D M. Radiofrequency ablation of breast cancer: first report of an emerging technology.  Arch Surg . 1999;  134 1064-1068
    PubMedGoogle Scholar
  • 21 Woertler K, Vestring T, Boettner F, Winkelmann W, Heindel W, Lindner N. Osteoid osteoma: CT-guided percutaneous radiofrequency ablation and follow-up in 47 patients.  J Vasc Interv Radiol . 2001;  12 717-722
    PubMedGoogle Scholar
  • 22 Lindner N J, Ozaki T, Roedl R, Gosheger G, Winkelmann W, Wortler K. Percutaneous radiofrequency ablation in osteoid osteoma.  J Bone Joint Surg Br . 2001;  83 391-396
    CrossrefPubMedGoogle Scholar
  • 23 Witt J D, Hall-Craggs M A, Ripley P, Cobb J P, Bown S G. Interstitial laser photocoagulation for the treatment of osteoid osteoma.  J Bone Joint Surg Br . 2000;  82 1125-1128
    CrossrefPubMedGoogle Scholar
  • 24 Gangi A, Dietemann J L, Clavert J M. et al . Treatment of osteoid osteoma using laser photocoagulation. Appropos of 28 cases.  Rev Chir Orthop Reparatrice Appar Mot . 1998;  84 676-684
    PubMedGoogle Scholar
  • 25 Hargreaves G M, Adam R, Bismuth H. Results after nonsurgical local treatment of primary liver malignancies.  Langenbecks Arch Surg . 2000;  385 185-193
    CrossrefPubMedGoogle Scholar
  • 26 Goldberg S N, Gazelle G S, Mueller P R. Thermal ablation therapy for focal malignancy: a unified approach to underlying principles, technqiues, and diagnostic imaging guidance.  Am J Radiol . 2000;  174 323-331
    CrossrefPubMedGoogle Scholar
  • 27 Gazelle G S, Goldberg S N, Solbiati L, Livaraghi T. Tumor ablation with radiofrequency energy.  Radiology . 2000;  217 633-646
    CrossrefPubMedGoogle Scholar
  • 28 Honda N, Guo Q, Uchida H, Ohishi H, Hiasa Y. Percutaneuous hot saline injection therapy for hepatic tumors: an alternative to percutaneous ethanol injection therapy.  Radiology . 1994;  190 53-57
    PubMedGoogle Scholar
  • 29 Goldberg S N, Stein M, Gazelle G S, Sheiman R G, Kruskal J B, Clouse M E. Percutaneous radiofrequency tissue ablation: optimization of pulsed-RF technique to increase coagulation necrosis.  J Vasc Interv Radiol . 1999;  10 907-916
    CrossrefPubMedGoogle Scholar
  • 30 Solbiati L, Livraghi T, Goldberg S N, Ierace T, DellaNoce M, Gazelle G S. Percutaneous radiofrequency ablation of hepatic metastases from colorectal cancer: long term results in 117 patients.  Radiology . 2001;  221 159-166
    CrossrefPubMedGoogle Scholar
  • 31 Goldberg S N, Solbiati L, Hahn P F. et al . Large-volume tissue ablation with radiofrequency by using a clustered, internally-cooled electrode technique: laboratory and clinical experience in liver metastases.  Radiology . 1998;  209 371-379
    CrossrefPubMedGoogle Scholar
  • 32 Rossi S, Buscarini E, Garbagnati F. Percutaneous treatment of small hepatic tumors by an expandable RF needle electrode.  AJR Am J Roentgenol . 1998;  170 1015-1022
    PubMedGoogle Scholar
  • 33 Dupuy D E, Goldberg S N, Gazelle G S, Rosenthal D I. Cooled-tip radio-frequency ablation in the vertebral body: temperature distribution in the spinal canal (abst).  Radiology . 1997;  807(P) 330
    PubMedGoogle Scholar
  • 34 Livraghi T, Goldberg S N, Meloni F, Solbiati L, Gazelle G S. Hepatocellular carcinoma: comparison of efficacy between percutaneous ethanol instillation and radiofrequency.  Radiology . 1999;  210 655-661
    CrossrefPubMedGoogle Scholar
  • 35 Dodd III D G, Soulen M C, Kane R A. et al . Minimally invasive treatment of malignant hepatic tumors: at the threshold of a major breakthrough.  Radiographics . 2000;  20 9-27
    PubMedGoogle Scholar
  • 36 Gazelle G S, Goldberg S N, Solbiati L, Livraghi T. Tumor ablation with radiofrequency energy.  Radiology . 2000;  217 6333-6346
    PubMedGoogle Scholar
  • 37 McGahan J P, Dodd III D G. Radiofrequency ablation of the liver: current status.  AJR Am J Roentgenol . 2001;  176 3-16
    CrossrefPubMedGoogle Scholar
  • 38 Tuttle T. Hepatectomy for noncolorectal liver metastases. In: Curley SA, ed. Liver Cancer New York: Springer 1991: 201-211
    Google Scholar
  • 39 Curley S A, Izzo F. Radiofrequency ablation of primary and metastatic hepatic malignancies.  Int J Clin Oncol . 2002;  7 72-81
    PubMedGoogle Scholar
  • 40 Lambert L A, Colacchio T A, Barth Jr J R. Interval hepatic resection of colorectal metastases improves patient selection.  Arch Surg . 2000;  135 473-479
    CrossrefPubMedGoogle Scholar
  • 41 Liveraghi T, Solbiati L, Meloni F, Ierace T, Goldberg S N, Gazelle G S. Percutaneous radiofrequency ablation of liver metastases in potential candidates for resection: the “test-of-time” approach Cancer .  2003;  97(12) 3027-3035
    PubMedGoogle Scholar
  • 42 Livraghi T, Lazzaroni S, Meloni F. Radiofrequency thermal ablation of hepatocellular carcinoma.  Eur J Ultrasound . 2001;  13 159-166
    CrossrefPubMedGoogle Scholar
  • 43 Livraghi T, Meloni F, Goldberg S N, Lazzaroni S, Solbiati L, Gazelle G S. Hepatocellular carcinoma: radiofrequency ablation of medium and large lesions.  Radiology . 2000;  214 761-768
    CrossrefPubMedGoogle Scholar
  • 44 Curley S A, Izzo F, Delrio P. Radiofrequency ablation of unresectable primary and metastatic hepatic malignancies: results in 123 patients.  Ann Surg . 1999;  230 1-8
    CrossrefPubMedGoogle Scholar
  • 45 Rossi S, Distasi M, Buscarini E. Percutaneous RF interstitial thermal ablation in the treatment of hepatic cancer.  AJR Am J Roentgenol . 1996;  167 759-768
    PubMedGoogle Scholar
  • 46 Ikeda M, Okada S, Uena H. et al . Radiofrequency ablation and percutaneous ethanol injection in patients with small hepatocellular carcinoma: a comparative study.  Jpn J Clin Oncol . 2001;  31 322-326
    CrossrefPubMedGoogle Scholar
  • 47 Lencioni R A, Allgaier H, Cioni D. et al . Small hepatocellular carcinoma in cirrhosis: randomized comparison of radio-frequency thermal ablation versus percutaneous ethanol injection.  Radiology . 2003;  228 235-240
    CrossrefPubMedGoogle Scholar
  • 48 Livraghi T. Guidelines for treatment of liver cancer.  Eur J Ultrasound . 2001;  13 167-176
    CrossrefPubMedGoogle Scholar
  • 49 Fontana R J, Hamidullah H, Nghiem H. et al . Percutaneous radiofrequency thermal ablation of hepatocellular carcinoma: a safe and effective bridge to liver transplantation.  Liver Transpl . 2002;  8(12) 1165-1174
    CrossrefPubMedGoogle Scholar
  • 50 American Cancer Society. Cancer facts and figures. Washington, DC: American Cancer Society; 2002
  • 51 Bengstsson G, Carlsson G, Hafstrom L, Jonsson P-E. Natural history of patients with untreated liver metastses from colorectal cancer.  Am J Surg . 1981;  141 586-589
    CrossrefPubMedGoogle Scholar
  • 52 Hughes K S, Rosenstein R B, Songhorabodi S. et al . Resection of the liver for colorectal carcinoma metastases: a multi-institutional study of long-term survivors.  Dis Colon Rectum . 1988;  31 1-4
    PubMedGoogle Scholar
  • 53 De Baere T, Elias D, Dromain C. et al . Radiofrequency ablation of 100 hepatic metastases with a mean follow-up of more than 1 year.  AJR Am J Roentgenol . 2000;  175 1619-1625
    PubMedGoogle Scholar
  • 54 Adson M A. Resection of liver metastases-when is it worthwhile?.  World J Surg . 1987;  11 511-520
    CrossrefPubMedGoogle Scholar
  • 55 Elias D, Lasser P H, Montrucolli D. et al . Hepatectomy for liver metastases from breast cancer.  Eur J Surg Oncol . 1995;  21 510-513
    CrossrefPubMedGoogle Scholar
  • 56 Siperstein A E, Rogers S J, Hansen P D. et al . Laparoscopic thermal ablation of hepatic neuroendocrine tumor metastases.  Surgery . 1997;  122 1147-1155
    CrossrefPubMedGoogle Scholar
  • 57 Livraghi T, Goldberg S N, Solbitati L. et al . Percutaneous radiofrequency ablation of liver metastases from breat cancer: initial experience in 24 patients.  Radiology . 2001;  220 145-149
    PubMedGoogle Scholar
  • 58 Henn A R, Levine E A, McNulty W, Zagoria R J. Percutaneous radiofrequency ablation of hepatic metastases for symptomatic relief of neuroendocrine syndromes.  AJR Am J Roentgenol . 2003;  181 1005-1010
    PubMedGoogle Scholar
  • 59 Que F G, Nagorney D M, Batts K P. et al . Hepatic resection for metastatic neuroendocrine carcinomas.  Am J Surg . 1995;  169 196-202
    PubMedGoogle Scholar
  • 60 Siperstein A, Garland A, Engle K. et al . Local recurrence after laparoscopic radiofrequency thermal ablation of hepatic tumors.  Ann Surg Oncol . 2000;  7 106-113
    CrossrefPubMedGoogle Scholar
  • 61 Topal B, Aerts R, Penninckx F. Laparoscopic radiofrequency ablation of unresectable liver malignancies: feasibility and clinical outcome.  Surg Laparosc Endosc Percutan Tech . 2003;  13(1) 11-15
    CrossrefPubMedGoogle Scholar
  • 62 Wood T F, Rose D M, Chung M. et al . Radiofrequency ablation of 231 unresectable hepatic tumors: indications, limitations, and complications.  Ann Surg Oncol . 2000;  7 593-600
    Google Scholar
  • 63 Goldberg S N, Hahn P F, Tanabe K K. et al . Percutaneous radiofrequency tissue ablation:does perfusion-mediated tissue cooling limit coagulation necrosis?.  J Vasc Interv Radiol . 1998;  9 101-111
    CrossrefPubMedGoogle Scholar
  • 64 Curley S A, Davidson B S, Fleming R Y. et al . Laparoscopically guided bipolar radiofrequency ablation of areas of porcine liver.  Surg Endosc . 1997;  11 729-733
    CrossrefPubMedGoogle Scholar
  • 65 Buscarini L, Buscarini E, Di Stasi M, Quaretti P, Zangrandi A. Percutaneous radiofrequency thermal ablation combined with transcatheter arterial embolization in the treatment of large hepatocellular carcinoma.  Ultraschall Med . 1999;  20 47-53
    Article in Thieme ConnectPubMedGoogle Scholar
  • 66 Aschoff A J, Merkle E M, Wong V. et al . How does alteration of hepatic blood flow affect liver perfusion and radiofrequency-induced thermal lesion size in rabbit liver?.  J Magn Reson Imaging . 2001;  13 57-63
    CrossrefPubMedGoogle Scholar
  • 67 De Baere T, Bessoud B, Dromain C. et al . Percutaneous radiofrequency ablation of hepatic tumors during temporary venous occlusion.  AJR Am J Roentgenol . 2002;  178 53-59
    CrossrefPubMedGoogle Scholar
  • 68 Miao Y, Ni Y, Yu J, Zhang H, Baert A, Marchal G. An ex vivo study on radiofrequency tissue ablation: increased lesion size by using an “expandable-wet” electrode.  Eur Radiol . 2001;  11 1841-1847
    CrossrefPubMedGoogle Scholar
  • 69 Giorgio A, Tarantino L, de Stefano G. et al . Percutaneous sonographically guided saline-enhanced radiofrequency ablation of hepatocellular carcinoma.  AJR Am J Roentgenol . 2003;  181 479-484
    PubMedGoogle Scholar
  • 70 Hansler J, Frieser M, Schaber S. et al . Radiofrequency ablation of hepatocellular carcinoma with a saline solution perfusion device: a pilot study.  J Vasc Interv Radiol . 2003;  14 575-580
    PubMedGoogle Scholar
  • 71 Kettenbach J, Kostler W, Rucklinger E. et al . Percutaneous saline-enhanced radiofrequency ablation of unresectable hepatic tumors: initial experience in 26 patients.  AJR Am J Roentgenol . 2003;  180 1537-1545
    PubMedGoogle Scholar
  • 72 Goldberg S N, Kamel I R, Kruskal J B. et al . Radiofrequency ablation of hepatic tumors: increased tumor destruction with adjuvant liposomal doxorubicin therapy.  AJR Am J Roentgenol . 2002;  179 93-101
    CrossrefPubMedGoogle Scholar
  • 73 Kitamoto M, Imagawa M, Yamada H. et al . Radiofrequency ablation in the treatment of small hepatocellular carcinomas: Comparison of the radiofrequency effect with and without chemoembolization.  AJR Am J Roentgenol . 2003;  181 997-1003
    PubMedGoogle Scholar
  • 74 Goldberg S N, Kruskal J B, Oliver B S, Clouse M E, Gazelle G S. Percutaneous tumor ablation: increased coagulation by combining radiofrequency ablation and ethanol instillation in a rat breast tumor model.  Radiology . 2000;  217 827-831
    PubMedGoogle Scholar
  • 75 Solbiati L, Goldberg S N, Ierace T, Dellanoce M, Livraghi T, Gazelle G S. Radiofrequency ablation of hepatic metastases: Postprocedural assessment with a US microbubble contrast agaent- early experience.  Radiology . 1999;  211 643-649
    PubMedGoogle Scholar
  • 76 Wen Y L, Kudo M, Zheng R Q. et al . Radiofrequency ablation of hepatocellular carcinoma: Therapeutic response using contrast-enhanced coded phase-inversion harmonic sonography.  AJR Am J Roentgenol . 2003;  181 57-63
    PubMedGoogle Scholar
  • 77 Numata K, Isozaki T, Ozawa Y. et al . Percutaneous ablation therapy guided by contrast-enhanced sonography for patients with hepatocellular carcinoma.  AJR Am J Roentgenol . 2003;  180 143-149
    PubMedGoogle Scholar
  • 78 Cioni D, Lencioni R, Rossi S. et al . Radiofrequency thermal ablation of hepatocellular carcinoma: using contrast-enhanced harmonic power doppler sonography to assess treatment outcome.  AJR Am J Roentgenol . 2001;  177 783-788
    PubMedGoogle Scholar
  • 79 Meloni M F, Goldberg S N, Livraghi T. et al . Hepatocellular carcinoma treated with radiofrequency ablation: comparison of pulse inversion contrast-enhanced harmonic sonography, contrast-enhanced power Doppler sonography, and helical CT.  AJR Am J Roentgenol . 2001;  177 375-380
    PubMedGoogle Scholar
  • 80 Morimoto M, Sugimori K, Shirato K. et al . Treatment of hepatocellular carcinoma with radiofrequency ablation: radiologic-histologic correlation during follow-up periods.  Hepotology . 2002;  35 1467-1475
    CrossrefPubMedGoogle Scholar
  • 81 Goldberg S N, Charboneau J W, Dodd G D. et al . Image-guided tumor ablation: proposal for stardardization of terms and reporting criteria.  Radiology . 2003;  228 335-345
    PubMedGoogle Scholar
  • 82 Boaz T L, Lewin J S, Chung Y C, Duerk J L. MR monitoring of MR-guided radiofrequency thermal ablation of normal liver in an animal model.  J Magn Reson Imaging . 1998;  8 64-69
    CrossrefPubMedGoogle Scholar
  • 83 Steiner P, Botnar R, Goldberg S N, Gazelle G S, Debtin J F. Monitoring of radiofrequency tissue ablation in an interventional MR environment: preliminary ex vivo and in vivo results.  Invest Radiol . 1997;  32 671-678
    CrossrefPubMedGoogle Scholar
  • 84 Anderson G S, Brinkmann F, Soulen M C, Alavi A, Zhuang H. FDG positron emission tomography in the surveillance of hepatic tumors treated with radiofrequency ablation.  Clin Nucl Med . 2003;  28 192-197
    CrossrefPubMedGoogle Scholar
  • 85 Livraghi T, Solbiati L, Meloni M F. et al . Treatment of focal liver tumors with percutaneous complications encountered in a multicenter study.  Radiology . 2003;  226 441-451
    CrossrefPubMedGoogle Scholar
  • 86 Llovet J M, Vilana R, Bru C. et al . Increased risk of tumor seeding after Percutaneous radiofrequency ablation for single hepatocellular carcinoma.  Hepatology . 2001;  33 1124-1129
    CrossrefPubMedGoogle Scholar
  • 87 De Sio I, Castellano L, De Girolamo V. et al . Tumor dissemination after radiofrequency ablation of hepatocellular carcinoma.  Hepatology . 2001;  34 609-610
    CrossrefPubMedGoogle Scholar
  • 88 Livraghi T, Vettori C, Torzilli G. et al . Percutaneous ethanol injection of hepatic tumors single-session therapy under general anesthesia.  AJR Am J Roentgenol . 1993;  160 1065-1069
    PubMedGoogle Scholar
  • 89 Molmenti E P, Marsh J W, Dvorchik I. et al . Hepatobiliary malignancies: primary hepatic malignant neoplasms.  Surg Clin North Am . 1999;  79 43-57
    CrossrefPubMedGoogle Scholar
  • 90 De Baere T, Risse O, Kuoch V. et al . Adverse events during radiofrequency treatment of 582 hepatic tumors.  AJR Am J Roentgenol . 2003;  181 695-700
    CrossrefPubMedGoogle Scholar
  • 91 Chopra S, Dodd G D, Chanin M P, Chintapalli K N. Radiofrequency ablation of hepatic tumors adjacent to the gall bladder: feasibility and safety.  AJR Am J Roentgenol . 2003;  180 697-701
    PubMedGoogle Scholar
  • 92 Titton R L, Gryzenia P C, Gervais D A. et al . Continuous high-output drainage of hepatic abscess 3 months after radiofrequency ablation of hepatocellular carcinoma.  AJR Am J Roentgenol . 2003;  180 1079-1084
    PubMedGoogle Scholar
  • 93 Lu D S, Raman S S, Vodopich D J. et al . Effect on vessel size on creation of hepatic radiofrequency lesions in pigs: assessment of the “heat sink” effect.  AJR Am J Roentgenol . 2002;  178 47-51
    CrossrefPubMedGoogle Scholar
  • 94 Shibata T, Limuro Y, Yamamoto Y. et al . Small hepatocellular carcinoma: comparison of radio-frequency ablation and percutaneous microwave coagulation therapy.  Radiology . 2002;  223 331-337
    CrossrefPubMedGoogle Scholar
  • 95 Goldberg S N. Comparison of techniques of image-guided ablation of focal liver tumors.  Radiology . 2002;  223 304-307
    PubMedGoogle Scholar
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