Percutaneous Ablation for Hepatocellular Carcinoma: Comparison of Various Ablation Techniques and Surgery

Figure 4

In live demonstrations, we perform ablation on various cases: a case of first diagnosed cancer not difficult to ablate judging from its size and location, a case of a tumor beneath the diaphragm requiring artificial ascites, a case of a tumor in the caudate lobe, a case of a tumor adjacent to the heart, a case of a tumor next to portal vein or hepatic vein at porta hepatis, a case of a tumor over 5 cm in diameter, a case of more than five tumors, cases of hepatic metastasis from the colorectal cancer or the gastric cancer, a case of simple nodular type HCC with extranodular growth or confluent multinodular type HCC, a case of a tumor with unclear boundaries on ultrasound which requires contrast-enhanced ultrasound to perform RFA, a case in which a tumor cannot be detected on ultrasound and requires support of fusion imaging, and others. From these cases, we demonstrate the importance of appropriate patient posture, usefulness of our original dedicated probe for interventional procedures and our RFA dedicated operation table, and the way to carry out ablation under contrast-enhanced ultrasound guidance and with multimodality fusion imaging.