CT-guided Percutaneous Microwave Coagulation Therapy for Small Hepatocellular Carcinoma

Yuji Yamamoto, Motomichi Sato, Yuji Watanabe, Takahiro Shiozaki, Hiroyuki Kikkawa, Hideaki Suzuki, Katsutoshi Miyauchi, Noboru Nakano and Kanji Kawachi

Department of Surgery II, School of Medicine, Ehime University

Four patients, aged 63-72 years, with small hepatocellular carcinoma (HCC) were treated with computed tomography (CT) -guided percutaneous microwave coagulation therapy (PMCT). Not all tumors were demonstrable by sonography due to their size or tumor location. All patients had a solitary HCC nodule in the right hepatic lobe from 9 to 20 mm in diameter. Three had HCC nodule recur after surgery. All received transcatheter arterial embolization using Lipiodol. All nodules were represented as Lipiodol spots on subsequent CT serving as marker for CT-guided localization and needle puncture. Distances between the skin puncture point and target nodules ranged from 27 to 62 mm. Tumor puncture with a fine needle and subsequent placement of the PMCT needle were without complication. All treated nodules were surrounded by non attenuated areas on dynamic CT using contrast enhancement, indicating complete tumor necrosis. No local recurrence was seen in the treated lesions. Three patients are still alive and died of multiple intrahepatic HCC recurrence. In conclusion: CT-guided PMCT is useful for in detecting small HCCs not found by sonography.

Key words
microwave coagulation therapy, hepatocellular carcinoma, computed tomography

Reprint requests
Yuji Yamamoto Department of SurgeryII Ehime University School of Medicine Shitsukawa, Shigenobu, Ehime 791-0295 JAPAN

Accepted
April 25, 2001

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