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Image-Guided Cancer Therapy pp 317–326Cite as

Percutaneous Ethanol Injection Injectables in the Treatment of Primary Liver Cancers

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Abstract

Percutaneous local ablation therapy is the best treatment option for patients with early-stage hepatocellular carcinoma (HCC) who are not suitable for resection or transplantation. Percutaneous ethanol injection (PEI) is the first mainstream modality of ablation and used to be a standard alternative therapy for unresectable small HCCs since the 1980s. To achieve complete devitalization of the tumor, conventional PEI using a fine needle usually needs multiple treatment sessions dependent on the tumor size, typically 4–12 sessions at twice-weekly interval. Conventional PEI offers satisfactory local efficacy and long-term survival in treating tumors smaller than 3 cm, but unsatisfactory complete response of tumors larger than 3 cm, mainly because of the influence of intratumoral septa. There have been major efforts to develop new methods for solving this problem. Single-session high-dose PEI using a single needle, simultaneous multiple needles, and a multi-pronged needle was subsequently applied. The latest multi-pronged PEI injection devices achieve better local efficacy than conventional PEI and are able to treat early-stage or recurrent HCC up to 5 cm effectively and safely, even for lesions at high-risk locations. Combined use of PEI with radio-frequency ablation may potentially improve the local efficacy of both techniques. Compared with radio-frequency ablation, PEI has the advantages of minor side effects, simplicity, and low cost. Local efficacy of PEI has been improved by innovative technique. Therefore, PEI will continue to play a role in the treatment of HCC.

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Author information

Authors and Affiliations

  1. Department of Hepatobiliary Surgery and Division of Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhong Shan Road 2, Guangzhou, 510080, China

    Ming Kuang

  2. Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhong Shan Road 2, Guangzhou, 510080, China

    Ming-De Lu

Authors
  1. Ming Kuang
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  2. Ming-De Lu
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Corresponding author

Correspondence to Ming Kuang .

Editor information

Editors and Affiliations

  1. The Warren Alpert Medical School of Brown University, Department of Diagnostic Imaging Rhode Island Hospital, Providence, Rhode Island, USA

    Damian E. Dupuy

  2. Department of Surgery and Radiology Memorial Sloan-Kettering Cancer Center, New York, New York, USA

    Yuman Fong

  3. McMullen Consulting, LLC, Surprise, Arizona, USA

    William N. McMullen

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Kuang, M., Lu, MD. (2013). Percutaneous Ethanol Injection Injectables in the Treatment of Primary Liver Cancers. In: Dupuy, D., Fong, Y., McMullen, W. (eds) Image-Guided Cancer Therapy. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0751-6_22

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  • DOI: https://doi.org/10.1007/978-1-4419-0751-6_22

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4419-0750-9

  • Online ISBN: 978-1-4419-0751-6

  • eBook Packages: MedicineReference Module Medicine

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