Journal of Liver Cancer

Recommendation and Guidelines

Local ablation for hepatocellular carcinoma: 2024 expert consensus-based practical recommendation of the Korean Liver Cancer Association: Seungchul Han, Pil Soo Sung, Soo Young Park, Jin Woong Kim, Hyun Pyo Hong, Jung-Hee Yoon, Dong Jin Chung, Joon Ho Kwon, Sanghyeok Lim, Jae Hyun Kim, Seung Kak Shin, Tae Hyung Kim, Dong Ho Lee, Jong Young Choi; J Liver Cancer. 2024;24(2):131-144. Published online August 30, 2024; DOI: https://doi.org/10.17998/jlc.2024.08.04

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Local ablation for hepatocellular carcinoma (HCC), a non-surgical option that directly targets and destroys tumor cells, has advanced significantly since the 1990s. Therapies with different energy sources, such as radiofrequency ablation, microwave ablation, and cryoablation, employ different mechanisms to induce tumor necrosis. The precision, safety, and effectiveness of these therapies have increased with advances in guiding technologies and device improvements. Consequently, local ablation has become the firstline treatment for early-stage HCC. The lack of organized evidence and expert opinions regarding patient selection, pre-procedure preparation, procedural methods, swift post-treatment evaluation, and follow-up has resulted in clinicians following varied practices. Therefore, an expert consensus-based practical recommendation for local ablation was developed by a group of experts in radiology and hepatology from the Research Committee of the Korean Liver Cancer Association in collaboration with the Korean Society of Image-guided Tumor Ablation to provide useful information and guidance for performing local ablation and for the pre- and posttreatment management of patients.

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Transarterial chemoembolization for hepatocellular carcinoma: 2023 expert consensus-based practical recommendations of the Korean Liver Cancer Association: Yuri Cho, Jin Woo Choi, Hoon Kwon, Kun Yung Kim, Byung Chan Lee, Hee Ho Chu, Dong Hyeon Lee, Han Ah Lee, Gyoung Min Kim, Jung Suk Oh, Dongho Hyun, In Joon Lee, Hyunchul Rhim; J Liver Cancer. 2023;23(2):241-261. Published online July 14, 2023; DOI: https://doi.org/10.17998/jlc.2023.05.22

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Abstract PDF

Transarterial chemoembolization (TACE) was introduced in 1977 with the administration of chemotherapeutic agent to gelatin sponge particles through the hepatic artery in patients with hepatocellular carcinoma (HCC) and was established as conventional TACE using Lipiodol in the 1980s. In the 2000s, drug-eluting beads were developed and applied clinically. Currently, TACE is a commonly used non-surgical treatment modality for patients with HCC who are unsuitable for curative treatment. Considering the vital role of TACE in the management of HCC, it is crucial to organize current knowledge and expert opinions regarding patient preparation, procedural techniques, and post-treatment care in TACE, which can enhance therapeutic efficacy and safety. A group of 12 experts in the fields of interventional radiology and hepatology, convened by the Research Committee of the Korean Liver Cancer Association (KLCA), has developed expert consensus-based practical recommendations in TACE. These recommendations have been endorsed by the Korean Society of Interventional Radiology and provide useful information and direction in performing TACE procedure as well as pre- and post- procedural patient care.

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Review Article

Technical Advances in Radiofrequency Ablation of Hepatocellular Carcinoma: Dongil Choi, Hyunchul Rhim, Min Woo Lee; Journal of the Korean Liver Cancer Study Group. 2012;12(1):14-15. Published online February 28, 2012

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Abstract PDF: 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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