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Angled Cool-Tip Electrode for Radiofrequency Ablation of Small Superficial Subcapsular Tumors in the Liver: A Feasibility Study

 Sung Il Park  ;  Il Jung Kim  ;  Shin Jae Lee  ;  Min Woo Shin  ;  Won Sun Shin  ;  Yong Eun Chung  ;  Gyoung Min Kim  ;  Man Deuk Kim  ;  Jong Yun Won  ;  Do Yun Lee  ;  Jin Sub Choi  ;  Kwang-Hyub Han 
 KOREAN JOURNAL OF RADIOLOGY, Vol.17(5) : 742-749, 2016 
Journal Title
Issue Date
Adult ; Aged ; Carcinoma, Hepatocellular/pathology ; Carcinoma, Hepatocellular/secondary ; Carcinoma, Hepatocellular/surgery* ; Catheter Ablation/adverse effects ; Catheter Ablation/instrumentation* ; Catheter Ablation/methods ; Electrodes ; Equipment Design ; Feasibility Studies ; Female ; Humans ; Liver Neoplasms/pathology ; Liver Neoplasms/surgery* ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Recurrence, Local/surgery ; Retrospective Studies ; Tomography, X-Ray Computed
Angled electrode ; Hepatoma ; Metastasis ; Radiofrequency ablation ; Subcapsular ; Superficial ; Technique
OBJECTIVE: To evaluate the feasibility of angled cool-tip electrode for radiofrequency ablation of small superficial subcapsular liver tumors abutting abdominal wall, in order to traverse normal liver parenchyma, and thereby, obtain favorable configuration of ablation margin. MATERIALS AND METHODS: In this study, we retrospectively analyzed 15 small superficial subcapsular liver tumors abutting abdominal wall in 15 patients, treated with radiofrequency ablation from March 2013 to June 2015 using a cool-tip electrode manually modified to create 25-35° angle at the junction between exposed and insulated segments. The tumors were hepatocellular carcinoma (n = 13) and metastases (n = 2: cholangiocellular carcinoma and rectosigmoid cancer), with maximum diameter of 10-26 mm (mean, 15.68 ± 5.29 mm). Under ultrasonographic guidance, the electrode tip was advanced to the depth of the tumors' epicenter about 1 cm from the margin. The tip was re-directed to penetrate the tumor for radiofrequency ablation. Minimal ablation margin was measured at immediate post-treatment CT. Radiological images and medical records were evaluated for success rate, length of minimal ablation margin and complications. RESULTS: Technical success rate of obtaining complete necrosis of the tumors was 100%, with no procedure-related complication. Minimal ablation margin ranged from 3-12 mm (mean, 7.07 ± 2.23 mm). CT/MRI follow-up at 21-1022 days (mean, 519.47 ± 304.51 days) revealed no local recurrence, but distant recurrence in 9 patients. CONCLUSION: Using an angled cool-tip electrode for radiofrequency ablation of small superficial subcapsular tumors abutting abdominal wall may be a feasible technique for obtaining adequate ablation margin and lower complication rate.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Gyoung Min(김경민) ORCID logo https://orcid.org/0000-0001-6768-4396
Kim, Man Deuk(김만득) ORCID logo https://orcid.org/0000-0002-3575-5847
Park, Sung Il(박성일)
Shin, Min Woo(신민우)
Shin, Won Seon(신원선)
Won, Jong Yun(원종윤) ORCID logo https://orcid.org/0000-0002-8237-5628
Lee, Do Yun(이도연)
Chung, Yong Eun(정용은) ORCID logo https://orcid.org/0000-0003-0811-9578
Choi, Jin Sub(최진섭)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
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