Skip to main content
SpringerLink
Log in

Combination therapy by transarterial injection of miriplatin-iodized oil suspension with radiofrequency ablation (RFA) versus microwave ablation (MWA) for small hepatocellular carcinoma: a comparison of therapeutic efficacy

  • Original Article
  • Published:
Japanese Journal of Radiology Aims and scope Submit manuscript

Abstract

Purpose

To compare the technical efficacy and complications of the transarterial injection of a miriplatin-iodized oil suspension combined with radiofrequency ablation (RFA) or microwave ablation (MWA) in the treatment of small hepatocellular carcinomas (HCCs).

Materials and methods

This retrospective study included 123 HCCs in 101 patients treated with the transarterial injection of a miriplatin-iodized oil suspension and RFA (MPT-RFA) (maximum diameter: 1.5 \(\pm \) 0.5 cm, range: 0.6–3.0 cm) and 68 HCCs in 49 patients treated with the transarterial injection of a miriplatin-iodized oil suspension and MWA (MPT-MWA) (maximum diameter: 1.6 \(\pm \) 0.7 cm, range: 0.5–3.0 cm). Technical success was defined as the achievement of an ablative margin of at least 5 mm for each tumor. Technical success, complications, and local tumor progression were compared between the two groups.

Results

The initial technical success rate was significantly higher with MPT-MWA (94.1%) than with MPT-RFA (76.4%; P = 0.003). The number of treatment sessions per nodule was significantly lower with MPT-MWA (1.1) than with MPT-RFA (1.3) (P = 0.004). The major complication rates were similar with MPT-RFA (5.8%) and MPT-MWA (2.7%) (P = 0.391). The one-year local tumor progression rate was similar between MPT-RFA (0%) and MPT-MWA (0%) (P = 0.73).

Conclusion

MPT-MWA may have improved therapeutic efficiency in the treatment of small HCCs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Villanueva A. Hepatocellular carcinoma. N Engl J Med. 2019;380(15):1450–62.

    Article  CAS  Google Scholar 

  2. Kim JW, Kim JH, Won HJ, Shin YM, Yoon HK, Sung KB, et al. Hepatocellular carcinomas 2–3 cm in diameter: transarterial chemoembolization plus radiofrequency ablation vs. radiofrequency ablation alone. Eur J Radiol. 2012;81(3):e189–93.

    Article  Google Scholar 

  3. Tamai T, Oshige A, Tabu K, Tabu E, Ijyuin S, Sakae H, et al. Utility of percutaneous radiofrequency ablation alone or combined with transarterial chemoembolization for early hepatocellular carcinoma. Oncol Lett. 2017;14(3):3199–206.

    Article  Google Scholar 

  4. Takahashi S, Kudo M, Chung H, Inoue T, Ishikawa E, Kitai S, et al. Initial treatment response is essential to improve survival in patients with hepatocellular carcinoma who underwent curative radiofrequency ablation therapy. Oncology. 2007;72(Suppl 1):98–103.

    Article  Google Scholar 

  5. Xu Z, Xie H, Zhou L, Chen X, Zheng S. The combination strategy of transarterial chemoembolization and radiofrequency ablation or microwave ablation against hepatocellular carcinoma. Anal Cell Pathol (Amst). 2019;2019:8619096.

    Google Scholar 

  6. Yamakado K, Takaki H, Nakatsuka A, Yamaknaka T, Fujimori M, Hasegawa T, et al. Radiofrequency ablation for hepatocellular carcinoma. Gastrointest Interv. 2014;3(1):35–9.

    Article  Google Scholar 

  7. Fujimori M, Takaki H, Nakatsuka A, Uraki J, Yamanaka T, Hasegawa T, et al. Survival with up to 10-year follow-up after combination therapy of chemoembolization and radiofrequency ablation for the treatment of hepatocellular carcinoma: single-center experience. J Vasc Interv Radiol. 2013;24(5):655–66.

    Article  Google Scholar 

  8. Morimoto M, Numata K, Nozawa A, Kondo M, Nozaki A, Nakano M, et al. Radiofrequency ablation of the liver: extended effect of transcatheter arterial embolization with iodized oil and gelatin sponge on histopathologic changes during follow-up in a pig model. J Vasc Interv Radiol. 2010;21(11):1716–24.

    Article  Google Scholar 

  9. Kim W, Cho SK, Shin SW, Hyun D, Lee MW, Rhim H. Combination therapy of transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) for small hepatocellular carcinoma: comparison with TACE or RFA monotherapy. Abdom Radiol (NY). 2019;44(6):2283–92.

    Article  Google Scholar 

  10. Nakajima K, Yamanaka T, Nakatsuka A, Haruyuki T, Fujimori M, Sugino Y, et al. Clinical utility of radiofrequency ablation following transarterial injection of miriplatin-iodized oil suspension in small hepatocellular carcinoma. Jpn J Radiol. 2016;34(9):640–6.

    Article  CAS  Google Scholar 

  11. Hasegawa T, Takaki H, Yamanaka T, Fujimori M, Nakatsuka A, Uraki J, et al. Experimental assessment of temperature influence on miriplatin and cisplatin iodized-oil suspension viscosity. Jpn J Radiol. 2013;31(6):424–7.

    Article  CAS  Google Scholar 

  12. Seko Y, Ikeda K, Kawamura Y, Fukushima T, Hara T, Sezaki H, et al. Antitumor efficacy of transcatheter arterial chemoembolization with warmed miriplatin in hepatocellular carcinoma. Hepatol Res. 2013;43(9):942–9.

    Article  CAS  Google Scholar 

  13. Hasegawa T, Takaki H, Miyagi H, Nakatsuka A, Uraki J, Yamanaka T, et al. Hyaluronic acid gel injection to prevent thermal injury of adjacent gastrointestinal tract during percutaneous liver radiofrequency ablation. Cardiovasc Intervent Radiol. 2013;36(4):1144–6.

    Article  Google Scholar 

  14. Yamakado K, Nakatsuka A, Takaki H, Sakurai H, Isaji S, Yamamoto N, et al. Subphrenic versus nonsubphrenic hepatocellular carcinoma: combined therapy with chemoembolization and radiofrequency ablation. Am J Roentgenol. 2010;194(2):530–5.

    Article  Google Scholar 

  15. Choe J, Kim KW, Kim YI, Chung JW, Huh J, Park J, et al. Feasibility of a low-power radiofrequency ablation protocol to delay steam popping. J Vasc Interv Radiol. 2016;27(2):268–74.

    Article  Google Scholar 

  16. Ahmed M, Solbiati L, Brace CL, Breen DJ, Callstrom MR, Charboneau JW, et al. Image-guided tumor ablation: standardization of terminology and reporting criteria—a 10-year update. J Vasc Interv Radiol. 2014;25(11):1691-705 e4.

    Article  Google Scholar 

  17. Yamakado K, Nakatsuka A, Takaki H, Yokoi H, Usui M, Sakurai H, et al. Early-stage hepatocellular carcinoma: radiofrequency ablation combined with chemoembolization versus hepatectomy. Radiology. 2008;247(1):260–6.

    Article  Google Scholar 

  18. Alonzo M, Bos A, Bennett S, Ferral H. The emprint ablation system with thermosphere technology: one of the newer next-generation microwave ablation technologies. Semin Interv Radiol. 2015;32(4):335–8.

    Article  Google Scholar 

  19. Ierardi AM, Mangano A, Floridi C, Dionigi G, Biondi A, Duka E, et al. A new system of microwave ablation at 2450 MHz: preliminary experience. Updates Surg. 2015;67(1):39–45.

    Article  Google Scholar 

  20. Poulou LS, Botsa E, Thanou I, Ziakas PD, Thanos L. Percutaneous microwave ablation vs radiofrequency ablation in the treatment of hepatocellular carcinoma. World J Hepatol. 2015;7(8):1054–63.

    Article  Google Scholar 

  21. Vogl TJ, Nour-Eldin NA, Hammerstingl RM, Panahi B, Naguib NNN. Microwave ablation (MWA): basics, technique and results in primary and metastatic liver neoplasms—review article. Rofo. 2017;189(11):1055–66.

    Article  Google Scholar 

  22. Miyazaki M, Iguchi T, Takaki H, Yamanaka T, Tamura Y, Tokue H, et al. Ablation protocols and ancillary procedures in tumor ablation therapy: consensus from Japanese experts. Jpn J Radiol. 2016;34(9):647–56.

    Article  CAS  Google Scholar 

  23. Izumi N. Recent advances of radiofrequency ablation for early hepatocellular carcinoma. J Gastroenterol Hepatol. 2011;26(Suppl 1):115–22.

    Article  Google Scholar 

  24. Maeda M, Saeki I, Sakaida I, Aikata H, Araki Y, Ogawa C, et al. Complications after radiofrequency ablation for hepatocellular carcinoma: a multicenter study involving 9,411 Japanese patients. Liver cancer. 2020;9(1):50–62.

    Article  Google Scholar 

  25. Hermida M, Cassinotto C, Piron L, Assenat E, Pageaux GP, Escal L, et al. Percutaneous thermal ablation of hepatocellular carcinomas located in the hepatic dome using artificial carbon dioxide pneumothorax: retrospective evaluation of safety and efficacy. Int J Hyperth. 2018;35(1):90–6.

    Article  Google Scholar 

  26. Takaki H, Yamakado K, Nakatsuka A, Yamada T, Shiraki K, Takei Y, et al. Frequency of and risk factors for complications after liver radiofrequency ablation under CT fluoroscopic guidance in 1500 sessions: single-center experience. Am J Roentgenol. 2013;200(3):658–64.

    Article  Google Scholar 

  27. Facciorusso A, Serviddio G, Muscatiello N. Local ablative treatments for hepatocellular carcinoma: an updated review. World J Gastrointest Pharmacol Ther. 2016;7(4):477–89.

    Article  Google Scholar 

  28. Luo W, Zhang Y, He G, Yu M, Zheng M, Liu L, et al. Effects of radiofrequency ablation versus other ablating techniques on hepatocellular carcinomas: a systematic review and meta-analysis. World J Surg Oncol. 2017;15(1):126.

    Article  Google Scholar 

  29. Tan W, Deng Q, Lin S, Wang Y, Xu G. Comparison of microwave ablation and radiofrequency ablation for hepatocellular carcinoma: a systematic review and meta-analysis. Int J Hyperth. 2019;36(1):264–72.

    Google Scholar 

  30. Suwa K, Seki T, Tsuda R, Yamashina M, Murata M, Yamaguchi T, et al. Short term treatment results of local ablation with water-cooled microwave antenna for liver cancer: comparison with radiofrequency ablation. Mol Clin Oncol. 2020;12(3):230–6.

    CAS  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

We would like to thank Ryo Morita (Department of Diagnotic and Interventional Radiology, Hokkaido University Hospital) and Yukihiko Sato (Department of Radiology, Obihiro Kosei Hospital) for valuable technical advices.

Author information

Authors and Affiliations

  1. Department of Radiology, Obihiro Kosei Hospital, 1, W14, S10, Obihiro, Hokkaido, 0800024, Japan

    Noriyuki Miyamoto, Motoma Kanaya, Takaaki Fujii, Hirotaka Kato & Kyohei Kudo

  2. Department of Radiology, Hyogo College of Medicine, Mukogawa 1-1, Nishinomiya, Hyogo, Japan

    Naoya Kinota

Authors
  1. Noriyuki Miyamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Motoma Kanaya
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Takaaki Fujii
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hirotaka Kato
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kyohei Kudo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Naoya Kinota
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Noriyuki Miyamoto.

Ethics declarations

Conflict of interest

We have no conflicts of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Miyamoto, N., Kanaya, M., Fujii, T. et al. Combination therapy by transarterial injection of miriplatin-iodized oil suspension with radiofrequency ablation (RFA) versus microwave ablation (MWA) for small hepatocellular carcinoma: a comparison of therapeutic efficacy. Jpn J Radiol 39, 376–386 (2021). https://doi.org/10.1007/s11604-020-01064-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11604-020-01064-7

Keywords

Search

Navigation