Radiofrequency Ablation Using Cooled-Wet Electrode

Switching Bipolar Radiofrequency Ablation Using Cooled-Wet Electrode for Treatment of Hepatocellular Carcinoma: A Preliminary Study

To determine safety, ablative zone, technical success rate and early safety data of recently introduced cool-wet electrode in eligible patients who are indicative for radiofrequency ablation (RFA) for liver tumors.

To determine safety, ablative zone, technical success rate and early safety data (12 months local tumor progression rate) of recently introduced cooled-wet electrode in eligible patients who are indicative for radiofrequency ablation (RFA) for liver tumors in comparison with currently used separable clustered electrode in our institution. Owing to tissue cooling effect of internally cooled-wet electrode can be used in switching bipolar mode. Patients would be randomized into two groups (cool-wet electrode group and separable clustered electrode in switching monopolar mode). The results from this preliminary study would be used for main study to compare the efficacy and safety data between two electrodes in the future.

RFA is performed using three cool-wet electrodes in switching bipolar mode under the fused US guidance.

RFA is performed using three cooled-wet electrodes in switching bipolar mode. The electrode is anticipated to reduce tissue resistance by releasing small amount of saline during the procedure, which may lead larger ablative volume by delivering more RF energy.

technical success rate on 1 month follow-up which indicates no residual tumor on cross-sectional imaging (CT, MRI)

all complication rate and grades (according to Clavien system from I to III) related with RFA procedure

RFA is performed under real time US guidance and US is fused with pre-RFA CT or MRI before ablation of the index tumor. US/CT or US/MR fusion quality is assessed by an operator.

After performing RFA, patients were transferred CT unit to confirm immediate technique success. It is performed in both a) visual inspection using pre-and post-RFA images side-by-side comparison and b) software assisted inspection which register pre-and post-RFA scans. The results would be used to perform additional treatment (2nd look RFA).

Inclusion Criteria: all conditions have to be fulfilled. Diagnosed with HCC (1~5cm) according to AASLD guideline or LI-RADS on MDCT or liver MRI within 60 days before RFA liver metastasis histologically confirmed or characteristic findings on cross-sectional imaging signed informed consent treatment naive index tumor (no history of local treatment for an index tumor) Exclusion Criteria: more than three tumors in a patients tumor size larger than 5cm tumor attaches to central portal vein or hepatic vein Child-Pugh classification C uncorrected coagulopathy presence of extrahepatic metastases