Tae Wook Kang MD, Presenter: Nothing to Disclose

Hyunchul Rhim MD, PhD, Abstract Co-Author: Nothing to Disclose

Dongil Choi MD, Abstract Co-Author: Nothing to Disclose

Young-Sun Kim MD, Abstract Co-Author: Nothing to Disclose

Won Jae Lee MD, Abstract Co-Author: Nothing to Disclose

Hyo Keun Lim MD, Abstract Co-Author: Nothing to Disclose

Eun Young Kim MD, Abstract Co-Author: Nothing to Disclose

Sangyu Nam MD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

To evaluate the effect of artificial ascites on the safety and therapeutic efficacy of percutaneous radiofrequency (RF) ablation for hepatocellular carcinoma (HCC) abutting the diaphragm.

We retrospectively assessed 46 patients who underwent percutaneous RF ablation for single nodular (<4cm) HCC above the portal bifurcation level for the last 4 years. All patients underwent ultrasound-guided RF ablation using internally cooled electrodes as the first-line treatment; they were followed with CT for at least 7 months (mean: 15.1months). We divided patients into two subgroups based on whether artificial ascites (AA) was introduced prior to RF ablation or not: group A (AA group, n=20) vs. group B (non-AA group, n=26). We compared the two subgroups in terms of complications and therapeutic efficacy.

The degree of diaphragmatic swelling at immediate follow-up CT was more severe in group B than group A (mean thickness: 1.4 mm vs. 0.6mm, p=0.01). The right shoulder pain after procedure was more common in group B than group A (p=0.01). Although pleural effusion was more common in group A due to transdiaphragmatic ascites shifting, there was no major thoracic complications in the both groups. The technical success rate was higher in group A than group B (100% vs. 81%, p=0.06). The primary and secondary technical effectiveness rates in group A and group B were 100% vs. 89% (p=0.25) and 81% vs. 70% (p=0.41), respectively. The local tumor progression rate was lower in group A than in group B (20% vs. 33%, p=0.34).

Artificial ascites may decrease the possibility of collateral thermal injury and increase the therapeutic efficacy in percutaneous RF ablation for HCC abutting the diaphragm.

To support the rationale of artificial ascites in percutaneous RF ablation of HCC abutting the diaphragm.

Kang, T, Rhim, H, Choi, D, Kim, Y, Lee, W, Lim, H, Kim, E, Nam, S, et al, , et al, , Percutaneous Radiofrequency Ablation for Hepatocellular Carcinoma Abutting the Diaphragm: Effect of Artificial Ascites on Safety and Therapeutic Efficacy.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5011058.html