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Zentralbl Chir 2003; 128(11): 920-927
DOI: 10.1055/s-2003-44799
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© Georg Thieme Verlag Stuttgart · New York

Interventionell-radiologische Therapie bei Lebermetastasen

Percutaneous Treatment of Liver MetastasesJ. Trübenbach1 , D. Schmidt1 , P. L. Pereira 1
  • 1Radiologische Klinik, Abteilung für Radiologische Diagnostik, Eberhard-Karls-Universität Tübingen
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Publication History

Publication Date:
11 December 2003 (online)

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Zusammenfassung

Die interstitielle Tumortherapie von primären und sekundären Tumoren der Leber stellt ein noch junges, aber sich stets weitentwickelndes Verfahren dar. Unter den thermoablativen Verfahren hat insbesondere die Radiofrequenzablation (RFA) zunehmende Aufmerksamkeit erreicht, vornehmlich aufgrund des gegenüber den anderen Hyperthermieverfahren besseren Wirkungsgrades.
Diese Arbeit bietet einen Überblick über die Grundlagen, Technik, Indikationen und bisherigen klinischen Ergebnisse der RFA von Lebermetastasen.

Abstract

Thermal coagulation therapy is a rapidly evolving technique for the treatment of primary and secondary hepatic tumors. Radiofrequency is gaining most of the attention of these techniques due to its superior effectiveness.
This article outlines technical considerations, indications and clinical results with RF ablation in the liver.

Schlüsselwörter

Leber - Metastasen - Therapie - Radiofrequenz - Ablation

Key words

Liver - metastases - therapy - radiofrequency - ablation

Literatur

  • 1 Cady B, Jenkins R L, Steele G D. et al . Surgical margin in hepatic resection for colorectal metastasis: a critical and improvable determinant of outcome.  Ann Surg. 1998;  227 566-571
    CrossrefPubMedGoogle Scholar
  • 2 Chopra S, Dodd G D, Chintapalli K N, Leyendecker J R, Karahan O I, Rhim H. Tumor recurrence after radiofrequency thermal ablation of hepatic tumors: spectrum of findings on dual-phase contrast-enhanced CT.  Am J Roentgenol. 2001;  177 381-387
    PubMedGoogle Scholar
  • 3 Curley S A, Izzo F. Radiofrequency ablation of primary and metastatic hepatic malignancies.  Int J Clin Oncol. 2002;  7 72-81
    PubMedGoogle Scholar
  • 4 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
  • 5 Dodd G D, 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
  • 6 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
  • 7 Elias D, Goharin A, El Otmany A. et al . Usefulness of intraoperative radiofrequency thermoablation of liver tumours associated or not with hepatectomy.  Eur J Surg Oncol. 2000;  26 763-769
    CrossrefPubMedGoogle Scholar
  • 8 Goldberg S N, Gazelle G S, Compton C C, Mueller P R, Tanabe K K. Treatment of intrahepatic malignancy with radiofrequency ablation: radiologic-pathologic correlation.  Cancer. 2000;  88 2452-2463
    CrossrefPubMedGoogle Scholar
  • 9 Goldberg S N, Gazelle G S, Solbiati L, Rittman W J, Mueller P R. Radiofrequency tissue ablation: increased lesion diameter with a perfusion electrode.  Acad Radiol. 1996;  3 636-644
    CrossrefPubMedGoogle Scholar
  • 10 Goldberg S N, Hahn P F, Halpern E F, Fogle R M, Gazelle G S. Radio-frequency tissue ablation: effect of pharmacologic modulation of blood flow on coagulation diameter.  Radiology. 1998;  209 761-767
    CrossrefPubMedGoogle Scholar
  • 11 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
  • 12 Goldberg S N, Solbiati L, Hahn P F. et al . Large-volume tissue ablation with radio frequency by using a clustered, internally cooled electrode technique: laboratory and clinical experience in liver metastases.  Radiology. 1998;  209 371-379
    CrossrefPubMedGoogle Scholar
  • 13 Goldberg S N, Stein M C, Gazelle G S, Sheiman R G, Kruskal J B, Clouse M E. Percutaneous radiofrequency tissue ablation: optimization of pulsed-radiofrequency technique to increase coagulation necrosis.  J Vasc Interv Radiol. 1999;  10 907-916
    CrossrefPubMedGoogle Scholar
  • 14 Goslin R, Steele G, Zamcheck N, Mayer R, MacIntyre J. Factors influencing survival in patients with hepatic metastases from adenocarcinoma of the colon or rectum.  Dis Colon Rectum. 1982;  25 749-754
    PubMedGoogle Scholar
  • 15 Helmberger T, Holzknecht N, Schopf U. et al . Radiofrequenzablation von Lebermetastasen - Technik und erste Ergebnisse.  Radiologe. 2001;  41 69-76
    CrossrefPubMedGoogle Scholar
  • 16 Huppert P E, Trubenbach J, Schick F, Pereira P, Konig C, Claussen C D. MRT-gestützte Radiofrequenzablation hepatischer Neoplasien - Erste technische und klinische Erfahrungen.  Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr. 2000;  172 692-700
    PubMedGoogle Scholar
  • 17 Landis S H, Murray T, Bolden S, Wingo P A. Cancer statistics, 1999.  CA Cancer J Clin. 1999;  49 8-31
    CrossrefPubMedGoogle Scholar
  • 18 Lehnert T, Golling M. Indikationen und Ergebnisse der Lebermetastasenresektion.  Radiologe. 2001;  41 40-48
    CrossrefPubMedGoogle Scholar
  • 19 Leyendecker J R, Dodd G D, Halff G A. et al . Sonographically observed echogenic response during intraoperative radiofrequency ablation of cirrhotic livers: pathologic correlation.  AJR Am J Roentgenol. 2002;  178 1147-1151
    CrossrefPubMedGoogle Scholar
  • 20 Livraghi T, Goldberg S N, Lazzaroni S. et al . Hepatocellular carcinoma: radio-frequency ablation of medium and large lesions.  Radiology. 2000;  214 761-768
    CrossrefPubMedGoogle Scholar
  • 21 Livraghi T, Goldberg S N, Monti F. et al . Saline-enhanced radio-frequency tissue ablation in the treatment of liver metastases.  Radiology. 1997;  202 205-210
    PubMedGoogle Scholar
  • 22 Livraghi T, Goldberg S N, Solbiati L, Meloni F, Ierace T, Gazelle G S. Percutaneous radio-frequency ablation of liver metastases from breast cancer: initial experience in 24 patients.  Radiology. 2001;  220 145-149
    PubMedGoogle Scholar
  • 23 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
  • 24 Mahnken A H, Tacke J, Bucker A, Gunther R W. Perkutane Radiofrequenzablation maligner Leberläsionen: Erste Erfahrungen mit einem 200 W Generator.  Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr. 2002;  174 216-223
    PubMedGoogle Scholar
  • 25 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
  • 26 Nakamura S, Suzuki S, Baba S. Resection of liver metastases of colorectal carcinoma.  World J Surg. 1997;  21 741-747
    CrossrefPubMedGoogle Scholar
  • 27 Ott R, Wein A, Hohenberger W. Lebermetastasen - primäre oder multimodale Therapie?.  Chirurg. 2001;  72 887-897
    CrossrefPubMedGoogle Scholar
  • 28 Ravikumar T S. Interstitial therapies for liver tumors.  Surg Oncol Clin N Am. 1996;  5 365-377
    PubMedGoogle Scholar
  • 29 Rossi S, Di Stasi M, Buscarini E. et al . Percutaneous RF interstitial thermal ablation in the treatment of hepatic cancer.  AJR Am J Roentgenol. 1996;  167 759-768
    PubMedGoogle Scholar
  • 30 Rossi S, Garbagnati F, Lencioni R. et al . Percutaneous radio-frequency thermal ablation of nonresectable hepatocellular carcinoma after occlusion of tumor blood supply.  Radiology. 2000;  217 119-126
    CrossrefPubMedGoogle Scholar
  • 31 Shetty S K, Rosen M P, Raptopoulos V, Goldberg S N. Cost- effectiveness of percutaneous radiofrequency ablation for malignant hepatic neoplasms.  J Vasc Interv Radiol. 2001;  12 823-833
    PubMedGoogle Scholar
  • 32 Solbiati L, Goldberg S N, Ierace T. et al . Hepatic metastases: percutaneous radio-frequency ablation with cooled-tipp electrodes.  Radiology. 1997;  205 367-373
    PubMedGoogle Scholar
  • 33 Solbiati L, Ierace T, Goldberg S N. et al . Percutaneous US-guided radio-frequency tissue ablation of liver metastases: treatment and follow-up in 16 patients.  Radiology. 1997;  202 195-203
    CrossrefPubMedGoogle Scholar
  • 34 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
  • 35 Solbiati L, Livraghi T, Goldberg S N. et al . Percutaneous radio-frequency ablation of hepatic metastases from colorectal cancer: long-term results in 117 patients.  Radiology. 2001;  221 159-166
    CrossrefPubMedGoogle Scholar
  • 36 Trubenbach J, Huppert P E, Pereira P L, Ruck P, Claussen C D. Radiofrequenzablation der Leber in vitro: Effektivitätserhö hung mittels perfundierter Sonden.  Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr. 1997;  167 633-637
    PubMedGoogle Scholar
  • 37 Trubenbach J, Konig C W, Duda S H. et al . Perkutane Radiofrequenzablation hepatischer Neoplasien unter Verwendung von „Cluster ”-Ablationssonden - Erste klinische Erfahrungen.  Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr. 2000;  172 905-910
    Article in Thieme ConnectPubMedGoogle Scholar
  • 38 Vogl T J, Zangos S, Balzer J O, Thalhammer A, Mack M G. Transarterial chemoembolization of liver metastases: Indication, technique, results.  Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr. 2002;  174 675-683
    PubMedGoogle Scholar
  • 39 Wood T F, Rose D M, Chung M, Allegra D P, Foshag L J, Bilchik A J. Radiofrequency ablation of 231 unresectable hepatic tumors: indications, limitations, and complications.  Ann Surg Oncol. 2000;  7 593-600
    Google Scholar
  • 40 Zhang Q, Chung Y C, Lewin J S, Duerk J L. A method for simultaneous RF ablation and MRI.  J Magn Reson Imaging. 1998;  8 110-114
    PubMedGoogle Scholar

Dr. med. J. Trübenbach

Radiologische Klinik

Abteilung für Radiologische Diagnostik

Eberhard-Karls-Universität Tübingen

Hoppe-Seyler-Str. 3

72076 Tübingen

Phone: 0 70 71/29-8 66 76

Fax: 0 70 71/29-56 94

Email: jochen.truebenbach@med.uni-tuebingen.de

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