Advantages / disadvantages Advantages – No internal bleeding – No needle tract seeding – Less liver derangement Disadvantages – Needs general anaesthesia – Lengthened procedure
INDICATIONS / CONTRAINDICATIONS Complications Current results Background How HIFU works
Indications Small tumour – Less than 3cm: ablation rate >85% Centrally located / liver dome tumour Adjacent to major bile duct / veins Child’s C liver function Gross ascites Cheung TT et al. HPB 2013
Contraindications Not fit for general anaesthesia Cannot assume treatment position Very poor liver function Lesion not visualized by USG Overlying hollow viscus Deep tumour Tumour close to overlying rib
Bridging to transplant 3 patients in HIFU group received liver transplant Pathology – Complete necrosis (n=2) – 90% necrosis (n=1) Cheung TT et al. WJG 2013
Liver transplant candidate Effective bridging therapy to liver transplant Cheung TT et al. WJG 2013
Summary Current applications – Ablative therapy for small unresectable HCC Child’s C liver function Tumour close to major pedicle – Combined with TACE for large HCC – Bridging therapy to liver transplantation Under investigation More clinical studies warranted
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