Radiofrequenz-Thermoablation maligner Raumforderungen der Leber

Zusammenfassung

Der Einsatz von Radiofrequenz-Ablationssytemen in der Behandlung primärer und sekundärer Lebertumoren findet schnelle klinische Verbreitung, da sich diese Methode als einfach, wenig belastend für den Patienten, komplikationsarm und in den ersten größeren klinischen Studien als wirkungsvoll erwiesen hat. Die überwiegende Mehrzahl dieser Patienten eignet sich wegen der Tumorlokalisation oder bestehender Begleiterkrankungen nicht für eine chirurgische Therapie, so dass die Radiofrequenz-Thermoablation eine sinnvolle Alternative für inoperable Patienten mit malignen Lebertumoren darstellt. Mit dieser Methode wird hochfrequenter Wechselstrom über eine Nadelelektrode im Gewebe appliziert, die entstehende Hitze führt zu Koagulationsnekrose. Mit den derzeit zur Verfügung stehenden Systemen kann mit einer Applikation eine Nekrose von etwa 4 - 5 cm Durchmesser erzielt werden. Die Nadelelektrode wird üblicherweise US- oder CT-gezielt platziert. In der Nachsorge können CT und MRI verwendet werden, beide Modalitäten haben sich als gleichwertig in Bezug auf die Beurteilung des Behandlungserfolgs erwiesen.

Abstract

The clinical application of radiofrequency tumor ablation in primary liver tumors and metastatic liver disease is rapidly growing because this technique has proven to be simple, safe, and effective in first clinical studies. Most of the patients with malignant liver disease are not candidates for surgical resection due to localisation or comorbidity, so radiofrequency therapy offers a good alternative for inoperable patients. With this method, high frequency alternating current is delivered to tissue via a needle electrode, the produced heat leads to coagulation necrosis. The largest focus of necrosis that can be induced with the currently availiable systems is approximately 4 - 5 cm with a single application. The radiofrequency needle is usually placed with US or CT guidance. For follow up examinations CT and MRI can be used, they proved to be equally accurate in the assessment of treatment response.

Schlüsselwörter

Thermoablation - perkutane Tumorablation - Radiofrequenzablation - Lebertumor - Lebermetastasen

Key words

Thermoablation - percutaneous tumor ablation - radiofrequency ablation - liver tumor - liver metastases

Literatur

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