This study tests the hypothesis that use of the research RFA (Radiofrequency ablation) Physics Library will result in more frequent technical success (complete necrotization of target tissues) compared to ablations conducted without computer guidance. The RFA Physics Library -- a Planning and Guidance Platform (PGP) (NE Scientific, LLC) -- will be used to support percutaneous liver RFA under CT-guidance by assisting physicians in the identification of ablation targets, assessment of proper ablation probe placement, and projection of the created ablation zones on the CT image.
Patients referred for curative ablation of an HCC by consensus recommendation of the multidisciplinary Liver Tumor Clinic at a 400-bed academic cancer center from June 2018 through December 2021 were considered for participation in the study. Inclusion criteria : patient : over 18 years old , ble to provide informed consent, expected survival \>1 year lesion: HCC, \>2 cm in diameter, located \> 1 cm from any other lesion. procedure : completed using the support of the Accublate simulation software. Software detail at : Hoffer EK, Borsic A, Patel SD. Validation of Software for Patient-Specific Real-Time Simulation of Hepatic Radiofrequency Ablation. Acad Radiol. 2022 Oct;29(10):e219-e227. doi: 10.1016/j.acra.2021.12.018. PMID: 35039220; PMCID: PMC9276838 Treatment: CT-guided RFA with Boston Scientific LeVeen system, RF3000 Generator. . Prophylactic antibiotic General anesthesia; imaging during suspended ventilation, no PEEP Ablation per manufacturer's protocol. Target : tumor + 5 mm margin Planning, targeting, intraprocedural repositioning, assessment of ablation coverage using software simulation in conjunction with manufacturer's data map. Tract ablation Follow-up clinic visit with contrast-enhanced cross-sectional imaging (MRI or CT) at 3 months, then every 3 months x 2 years. Data review for complications, progression of liver disease, evidence of local, regional, or metastatic disease, and additional interventions. Outcome measures: primary : local tumor progression secondary: hepatic tumor progression
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
Research software used to support liver RFA of HCC lesions \>2cm
Dartmouth-Hitchcock Medical Center
Lebanon, New Hampshire, United States
Rate of Technical Success of Tumor Ablation
Technical success is defined as the complete ablation of the target lesion (tumor and 5 mm margin), as determined by operator.
Time frame: Success measured at end of RFA procedure, one-time event (lasting up to a few hours)
Rate of Local Tumor Recurrence
Local recurrence at 2 years is defined as the detection of viable malignant tissues at edge of or within a site which was previously treated by RFA.
Time frame: 2 years after RFA treatment
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
NONE
Enrollment
62