Zusammenfassung
Die Radiofrequenzablation ist eine vielversprechende und sich schnell weiterentwickelnde
Technik zur minimal invasiven Therapie von Lebermalignomen. Bis vor einigen Jahren
war der limitierende Faktor dieses Verfahrens der unter Verwendung der zur Verfügung
stehenden Ablationssonden maximal erzeugbare Läsionsdurchmesser von 1,6 cm. Entscheidende
Fortschritte erfuhr dieses Verfahren durch die Entwicklung leistungsfähigerer Generatoren
(bis 250 Watt) in Kombination mit offen oder geschlossen gekühlten Ablationssonden
bzw. expandierbaren Ablationssonden. Hiermit sind nunmehr Ablationsareale mit Durchmessern
bis über 5 cm in-vivo möglich. Weiterhin konnte mit angiographischen bzw. pharmakologischen
Strategien eine weitere Vergrößerung der Ablationsvolumina erzielt werden. In diesem
Artikel werden die grundlegenden Prinzipien der RF-Ablation sowie die aktuellsten
RF-Systeme im Hinblick auf die Ablationscharakteristika dargestellt.
Abstract
Radiofrequency (RF) thermal ablation is a promising and rapidly evolving technique
for the minimal invasive treatment of liver malignancies. Until a few years ago, conventional
RF treatment performed with a single monopolar electrode produced thermal necrosis
lesions not exceeding 1.6 cm in diameter. Substantial improvements in the RF technique
included the development of high-power generators (up to 250 watts) combined with
open-perfused electrodes, internally cooled-tip electrodes or expandable electrode
needles, capable of ablating an area of over 5 cm in diameter. Moreover, angiographically
and pharmacologically assisted strategies were introduced for expanding the volume
of RF-induced coagulation necrosis. This article presents a synopsis of current RF
techniques and reviews the basic principles of RF ablation with the goal of providing
guidance for optimal results.
Schlüsselwörter
Leber - Leber, Neoplasma - Leber, Therapie - Ablation, Radiofrequenz
Keywords
Liver - liver, neoplasms - liver, therapy - ablation, radiofrequency
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PD Dr. med. Philippe L. Pereira
Eberhard-Karls-Universität Tübingen
Abteilung für Radiologische Diagnostik
Hoppe-Seyler-Strasse 3
72076 Tübingen
Phone: +49 7071 2986676
Fax: +49 7071 295694
Email: philippe.pereira@med.uni-tuebingen.de
