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- New Techniques of Ultrasound-guided Radiofrequency Ablation for Hepatocellular Carcinoma
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Min Woo Lee
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J Liver Cancer. 2014;14(2):89-96. Published online September 30, 2014
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DOI: https://doi.org/10.17998/jlc.14.2.89
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Abstract
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- In Korea, radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC) is most widely
used under ultrasonography (US) guidance. With the technical development, small HCCs in
challenging locations can be ablated effectively. Both fusion imaging and contrast-enhanced
US is useful for identifying small inconspicuous HCCs on conventional US, thereby enable us
to conduct successful RFA. Artificial ascites can enhance ultrasonic window and is helpful in
avoiding thermal injury to the surrounding organs. Laparoscopy is also useful for guidance
of RFA for subcapsular HCCs which are difficult to approach percutaneously. (J Liver Cancer
2014;14:89-96)
- Management of Cirrhotic Complications in Hepatocellular Carcinoma: Portal Hypertension, Ascites, and Variceal Beeding
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Young Kul Jung, Duck Joo Choi
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Journal of the Korean Liver Cancer Study Group. 2012;12(2):85-87. Published online September 30, 2012
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Abstract
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- Hepatocellular carcinoma (HCC) causes approximately one million deaths every year. Due to advanced stage at diagnosis,
HCC carries a five-year survival rate of less than 5%, if diagnosed with unresectable disease. And also HCC is responsible for
significant morbidity and mortality in cirrhosis. It leads to decompensation of cirrhosis and is the cause of death in up to 25% of
cirrhotic patients. The purpose of this article is to provide an overview of the complexity in complication management of patients
with terminal stage of HCC. The occurrence of complications in HCC patients is common, and includes portal hypertension,
ascites, and variceal bleedings. Because of the limitations in the efficacy of current treatment options for terminal stage HCC,
complication management is a key to preserving physical functioning and quality of life in these patients. Until now, diuretics
remain the gold standard in management of ascites in cancer patients, and endoscopic treatment and vasoconstrictor are good
choice for acute variceal bleedings. In several studies, sorafenib showed a potential as therapeutics for portal hypertension in
patients with advanced HCC.
- Technical Advances in Radiofrequency Ablation of Hepatocellular Carcinoma
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Dongil Choi, Hyunchul Rhim, Min Woo Lee
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Journal of the Korean Liver Cancer Study Group. 2012;12(1):14-15. Published online February 28, 2012
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Abstract
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- Lots of recent technical advances in radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC) have introduced. First,
contrast-enhanced ultrasound can help to detect the index tumors, residual tumor, and local recurrence. After contrast-enhanced
ultrasound for subtle small tumors, we can perform RFA with high confidence. The use of artificial ascites in RFA is a simple and
useful technique to minimize collateral thermal injury and to improve the sonic window. Fusion imaging between US and CT or
MR during RFA is useful since US can provide real-time imaging and CT or MR provides high quality images with good contrast
and spatial resolution. RFA can be performed with fluoroscopy guidance to lipiodol retention tumors.
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