肝腫瘍のラジオ波焼灼治療・マイクロ波焼灼治療

抄録

Radiofrequency ablation (RFA) has been recommended as a first-line treatment for patients with solitary and small hepatocellular carcinoma (HCC) (<2 cm) in Barcelona Clinic Liver Cancer (BCLC) stage 0. This percutaneous image-guided procedure is safe and minimally invasive because it can be performed under moderate intravenous sedation. Additionally, locoregional treatment combined with systemic chemotherapy can improve treatment outcomes in patients with oligometastatic colorectal cancer. RFA is a treatment option for liver metastases from other malignancies, such as neuroendocrine tumors and breast cancer, if the patient is in an oligometastatic condition. Additionally, microwave ablation (MWA), employing a high-frequency band (2.45 GHz) and thermosphere technology, has been introduced as a new ablation modality.
Since 2022, the National Health Insurance in Japan has covered thermal ablation therapy in regions other than the liver and kidney. Therefore, interventional radiologists who are familiar with not only ultrasound but also computed tomography-guided procedures should be more concerned with percutaneous ablation therapy for liver tumors to improve treatment outcomes. Needless to say, a multidisciplinary team approach is needed for hepatic malignancies regardless of whether it is a primary or metastatic disease; however, it is essential for interventional radiologists to be well acquainted with hepatic ablation therapy. Herein, we describe the indications, basic techniques, treatment outcomes, and complications associated with this procedure.