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(Radiographics. 2000;20:9-27.)
© RSNA, 2000

IMAGING & THERAPEUTIC TECHNOLOGY

Minimally Invasive Treatment of Malignant Hepatic Tumors: At the Threshold of a Major Breakthrough1

Gerald D. Dodd, III, MD, Michael C. Soulen, MD , Robert A. Kane, MD , Tito Livraghi, MD , William R. Lees, MB BS, FRCR , Yasuyuki Yamashita, MD , Alison R. Gillams, MBChB, MRCP, FRCR , Okkes I. Karahan, MD and Hyunchul Rhim, MD, PhD

1 From the Departments of Radiology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX 78284-7800 (G.D.D., O.I.K., H.R.); University of Pennsylvania, Philadelphia (M.C.S); Beth Israel Deaconess Medical Center, Boston, Mass (R.A.K.); Ospedale Civile, Vimercate, Milan, Italy (T.L.); University College London, Middlesex Hospital, London, England (W.R.L., A.R.G.); Kumamoto University, Kumamoto, Japan (Y.Y); Erciyes University, Kayseri, Turkey (O.I.K); and Hanyang University, Seoul, South Korea (H.R). Recipient of a Summa Cum Laude award and an Excellence in Design award at the 1998 RSNA scientific assembly. Received May 17, 1999; revisions requested July 22 and received August 24; accepted August 25. Address reprint requests to G.D.D.

Six existing minimally invasive techniques for the treatment of primary and secondary malignant hepatic tumors—radio-frequency ablation, microwave ablation, laser ablation, cryoablation, ethanol ablation, and chemoembolization—are reviewed and debated by noted authorities from six institutions from around the world. All of the authors currently believe that surgery remains the treatment of choice for patients with resectable hepatic tumors. However, the clinical results of each of the minimally invasive techniques presented have exceeded those obtained with conventional chemotherapy or radiation therapy. Thus, for nonsurgical patients, these techniques are becoming standard independent or adjuvant therapies. In addition, with continued improvement in technology and increasing clinical experience, one or more of these minimally invasive techniques may soon challenge surgical resection as the treatment of choice for patients with limited hepatic tumor.

Index Terms: Alcohol ablation • Cryotherapy • Interventional procedures, technology • Lasers, interstitial therapy • Liver neoplasms, chemotherapeutic infusion, 761.1266 • Liver neoplasms, therapy, 761.1266 • Radiofrequency (RF) ablation




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