Effect of Perfluorobutane Microbubbles on Radiofrequency Ablation for Hepatocellular Carcinoma: Suppression of Steam Popping and Its Clinical Implication
정동영, 강태욱, 민지혜, 송경두, 이민우, 임현철, 임효근, 신동현, 한희원,
소속 상세정보
정동영 ( Jeong Dong-Young )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiology
강태욱 ( Kang Tae-Wook )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiology
민지혜 ( Min Ji-Hye )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiology
송경두 ( Song Kyoung-Doo )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiology
이민우 ( Lee Min-Woo )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiology
임현철 ( Rhim Hyun-Chul )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiology
임효근 ( Lim Hyo-Keun )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiology
신동현 ( Sinn Dong-Hyun )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine
한희원 ( Han Hee-Won )
Samsung Medical Center Research Institute for Future Medicine Statistics and Data Center
Abstract
Objective: To evaluate the effect of perfluorobutane microbubbles (Sonazoid®, GE Healthcare) on steam popping during radiofrequency (RF) ablation for treating hepatocellular carcinoma (HCC), and to assess whether popping affects treatment outcomes.
Materials and Methods: The institutional review board approved this retrospective study, which included 90 consecutive patients with single HCC, who received percutaneous RF ablation as the first-line treatment. The patients were divided into two groups, based on the presence or absence of the popping phenomenon, which was defined as an audible sound with a simultaneous sudden explosion within the ablation zone as detected via ultrasonography during the procedure. The factors contributing to the popping phenomenon were identified using multivariable logistic regression analysis. Local tumor progression (LTP) and disease-free survival (DFS) were assessed using the Kaplan-Meier method with the log-rank test for performing comparisons between the two groups.
Results: The overall incidence of the popping phenomenon was 25.8% (24/93). Sonazoid® was used in 1 patient (4.2%) in the popping group (n = 24), while it was used in 15 patients (21.7%) in the non-popping group (n = 69). Multivariable analysis revealed that the use of Sonazoid® was the only significant factor for absence of the popping phenomenon (odds ratio = 0.10, p = 0.048). There were no significant differences in cumulative LTP and DFS between the two groups (p = 0.479 and p = 0.424, respectively).
Conclusion: The use of Sonazoid® has a suppressive effect on the popping phenomenon during RF ablation in patients with HCC. However, the presence of the popping phenomenon may not affect clinical outcomes.
키워드
Liver; Hepatocellular carcinoma; Radiofrequency ablation; Contrast media; Explosions
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