Percutaneous cooled-probe microwave versus radiofrequency ablation in early-stage hepatocellular carcinoma: a phase III randomised controlled trial

We read with interest the article by Bruix et al1 on currently available treatment options for hepatocellular carcinoma (HCC). Radiofrequency ablation (RFA) is now the first-line technique for HCC ablation. RFA produces tumour necrosis in situ through temperature modification. Compared with RFA, microwave ablation (MWA) is one relatively recent advancement of thermoablative technology, which shows multiple theoretical advantages over RFA.2–4 We wish to report the results of a phase III randomised controlled trial (RCT) by comparing ultrasound-guided percutaneous cooled-probe MWA and RFA in ≤5 cm HCC (NCT 02539212). From October 2008 to June 2015, 203 (265 nodules) subjects were randomised to MWA and 200 (251 nodules) were randomised to RFA. The indications were as follows: tumour size ≤5 cm in diameter, tumour number ≤3, Child–Pugh class A or B classification, no evidence of extrahepatic metastasis, vein or bile duct tumour embolus, lesions...
Source: Gut - Category: Gastroenterology Authors: Tags: Open access PostScript Source Type: research

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Conclusion: Intraprocedural fusion imaging combining CEUS and auto sweep three-dimensional US appears to be a useful modality for RFA guidance and evaluation of therapeutic efficacy of RFA in patients with HCC. PMID: 32070164 [PubMed - in process]
Source: International Journal of Hyperthermia - Category: Internal Medicine Tags: Int J Hyperthermia Source Type: research
Contrast-enhanced ultrasound (CEUS) is a low cost and effective imaging modality that is accessible immediately post procedure which allows the clinician to instantly perform additional ablation of the tumor if a residual tumor is detected. CEUS can be an alternative to contrast enhanced CT in patients with underlying renal disease or iodine allergy. The purpose of this abstract is to share our experience with use of contrast enhanced ultrasound after microwave ablation for HCC with MRI correlation and posttransplant pathology.
Source: Journal of Vascular and Interventional Radiology : JVIR - Category: Radiology Authors: Tags: Scientific Session 14 Source Type: research
Despite the absence of high-quality randomized controlled trials, the results of meta-analyses and large prospective cohort studies suggest that ultrasound (US) surveillance for hepatocellular carcinoma (HCC) confers clinical benefit, with improved overall survival through detection of very early or early stage HCC leading to increased eligibility for potentially curative local treatments and transplantation.1,2 Moreover, the cost-effectiveness of periodical HCC surveillance was reported in patients with cirrhosis in France and the United States.
Source: Journal of Hepatology - Category: Gastroenterology Authors: Tags: Editorial Source Type: research
Low‑intensity ultrasound enhances the antitumor effects of doxorubicin on hepatocellular carcinoma cells through the ROS‑miR‑21‑PTEN axis. Mol Med Rep. 2020 Jan 13;: Authors: Xia C, Zeng H, Zheng Y Abstract Hepatocellular carcinoma (HCC) is a type of liver cancer and is a leading cause of cancer‑associated mortality. In China, ~466,000 patients are diagnosed with HCC and it is responsible for ~422,000 cases of mortality each year. Surgery is the most effective treatment available; however it is only suitable for patients with early‑stage HCC. Chemotherapy has been confirmed as a n...
Source: Molecular Medicine Reports - Category: Molecular Biology Tags: Mol Med Rep Source Type: research
AbstractDuring routine ultrasound examination, a hyperechoic mass was detected in the anterior segment of the liver in an 80-year-old woman with hepatitis C virus-related cirrhosis. Computed tomography and magnetic resonance imaging findings suggested a malignant tumor with abundant fibrous stroma, similar to cholangiolocellular carcinoma. However, subsequent partial hepatectomy revealed a mass characterized by abundant fibrosis without tumor cells, dilated blood vessels, and marginal ductular reaction. Accordingly, focal confluent fibrosis was diagnosed. Generally, the diagnosis of focal confluent fibrosis is straightforw...
Source: Abdominal Imaging - Category: Radiology Source Type: research
ConclusionsCEUS is highly efficient in differentiating TIV from PVT and is an alternative or a substitute for CT and/or MRI.Trial registrationPROSPERO registration number: CRD42019138847Key Points• Characterization of portal vein thrombosis (PVT) vs tumor-in-vein (TIV) is critical for HCC staging.• CEUS has an excellent safety profile, provides a real-time analysis without any loss in accuracy compared with CT and MRI.• This meta-analysis demonstrates that contrast-enhanced ultrasound (CEUS) is a suitable method for the detection of PVT and distinction with TIV.
Source: European Radiology - Category: Radiology Source Type: research
AbstractContrast-enhanced ultrasound (CEUS) greatly improved the diagnostic accuracy of US in the detection and characterization of focal liver lesions (FLLs), and it is suggested and often included in many international guidelines as an important diagnostic tool in the imaging work-up of cirrhotic patients at risk for developing hepatocellular carcinoma (HCC). In particular, CEUS Liver Imaging Reporting and Data System (LI-RADS) provides standardized terminology, interpretation, and reporting for the diagnosis of HCC. The aim of this pictorial essay is to illustrate CEUS features of nodules discovered at US in cirrhotic l...
Source: Insights into Imaging - Category: Radiology Source Type: research
Abstract Hepatic steatosis, or fatty liver disease, occurs due to the accumulation of lipids in hepatocytes. When it becomes chronic, lobular inflammation develops and the disease can evolve to hepatic fibrosis, liver cirrhosis, or hepatocellular carcinoma. Early diagnosis is desirable because patients diagnosed in the early stage of the disease respond better to treatment. In the early stages of fatty liver disease, the physical examination is often unremarkable. Fatty liver disease and hepatic fibrosis can be diagnosed and monitored through laboratory tests, imaging, and biopsy. Among the imaging methods, ultrasound stan...
Source: Radiologia Brasileira - Category: Radiology Source Type: research
We determined the clinical effectiveness and long-term outcomes in patients with distal biliary obstruction (DBO) secondary to pancreatic carcinoma (PC) who were treated by self-expanded metallic stent (SEMS) insertion with or without high-intensity focused ultrasound (HIFU) ablation. From January 2014 to December 2018, consecutive patients with DBO secondary to PC underwent SEMS insertion with or without HIFU ablation in our center. The long-term outcomes were compared between the 2 groups. During the included period, 75 patients underwent SEMS insertion with (n = 34) or without (n = 41) HIFU ablation in our cen...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Authors: Lang S, Martin A, Kasper P, Schramm C, Kütting F, Goeser T, Steffen HM, Demir M Abstract Objective: International guidelines recommend hepatocellular carcinoma (HCC) surveillance with ultrasound in high-risk patients with chronic liver diseases. However, there is low-strength evidence about the effects on mortality. The aim of our study was to assess the impact of surveillance on the clinical course and survival of HCC patients seen at a tertiary referral center in Germany.Material and methods: We retrospectively evaluated the data of 401 HCC patients, who presented to our clinic between 1997 and 2015...
Source: Scandinavian Journal of Gastroenterology - Category: Gastroenterology Tags: Scand J Gastroenterol Source Type: research
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