CT GUIDED RF ABLATION IN THE MANAGEMENT OF METASTATIC LIVER by mikesanye

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									            CT-GUIDED RF ABLATION IN THE MANAGEMENT OF METASTATIC LIVER DISEASE IN PANCREATIC
                                               CARCINOMA PATIENTS
                         S Mylona, D Gavrilou, A Lourbakou, N Karampas, N Lepida, N Batakis
                                         HELLENIC RED CROSS HOSPITAL
Purpose: To present our experience in RF ablation of                         aa                                  b
    metastatic liver disease in patients after surgical treated                                b
    pancreatic carcinoma.
Material and methods: In a 7 year period 30 patients
    underwent CT-guided RF ablation for the management
    of metastatic liver disease from pancreatic carcinoma.
    Twenty/30 of them had only one liver lesion, 8/30 had
                                                                      Fig. 1: a) RF ablation of a metastasis to the right lobe of the liver from
    two lesions and 2/30 patients had 3 lesions. Forty eight
    RFA sessions were performed totally for 42 liver                  adenocarcinoma of the pancreas, b) one month follow-up shows total necrosis
    lesions, under local anesthesia. An analgesic treatment           of the lesion
    45 min before the procedure was received.                                  a                                     b
    The mean ablation time was 15 minutes (11-18 min).                a                            b
    Follow-up was performed in 1-3-6-12 months and at 6m
    ever after.
Results: The 1st month imaging follow-up showed total
    necrosis in 37/42 of the lesions (technical success
    88%) (fig 1, 2). Five/42 (12%) tumors had partial                 Fig. 2: a) RF ablation of a hepatic metastasis from neuroendocrine tumor of
    necrosis and a second session was followed, which led             the pancreas, b) total necrosis of the lesion in one month follow-up
    to total necrosis (fig 3).                                        a                        b                         c
    The six month follow-up revealed multiple hepatic
    lesions in 5/30 patients.
    Twelve months after the first RFA session 3/30 patients       a                                b
    presented with a new lesion that treated with RFA too.
    No complications were observed.
Conclusion: In case of patients with pancreatic carcinoma             Fig. 3: a) RF ablation of a metastasis to the left lobe of the liver from
    deal with operation and metastatic liver disease, CT-             adenocarcinoma of the pancreas, b) one month follow-up shows partial
    guided RFA is a minimally invasive, acceptable, well              necrosis, c) a second RF ablation led to total necrosis of the lesion
    tolerated alternative treatment.
References: 1. Tumor Ablation with Radio-frequency Energy, G. Scott Gazelle, S. Nahum Goldberg, Luigi Solbiati, and Tito
Livraghi, Radiology, Dec 2000; 217: 633.
             2. Percutaneous Radio-frequency Ablation of Hepatic Metastases from Colorectal Cancer: Long-term Results in 117
Patients, Luigi Solbiati, Tito Livraghi, S. Nahum Goldberg, Tiziana Ierace, Franca Meloni, Marina Dellanoce, Luca Cova, Elkan F.
Halpern, and G. Scott Gazelle, Radiology, Oct 2001; 221: 159.
             3. Radio-frequency Ablation of Liver Tumors: Assessment of Therapeutic Response and Complications, Haesun
Choi, Evelyne M. Loyer, Ronelle A. DuBrow, Harmeet Kaur, Cynthia L. David, Steven Huang, Steven Curley, and Chusilp
Charnsangavej, RadioGraphics, Oct 2001; 21: S41 - S54.

								
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