New approaches in microwave coagulation therapy for hepatocellular carcinoma

Abstract

We divised several therapeutic tools ti extend indications of microwave coagulation therapy (MCT) for hepatocellular carcinoma (HCC). Percutaneous MCT under artificial hydrothorax or ascites was performd in the surface of the liver, respectively. Isoechoic hepatic tumors can be enhanced by intraarterial infusion of carbon dioxide microbubble in albumin solution, detecting as a high echoic tumor by ultrasound (CO₂ angio-US). It is extremely difficult to follow accurately the extent of MCT injury in real-time by US during procedure. However, the coagulation area over 4 cm in diameter can be achieved by multi-needle insertion technique. Thus, we indicate percutaneous MCT for HCC under 3 cm in diameter. In patients with large hepatic tumors, transcatheter arterial chemoembolization reduced the tumor size and able to indicate for HCC by which complete tumor necrosis can be obtained. HCC located adjacent to the Glisson capsule of the liver was treated by MCT under biliary cooling to prevent bile duct injury. In conclusion, our new devuces make to extend the indication of MCT for HCC. Thus, MCT may be a safe and more applicable therapeutic modalities for HCC.