Percutaneous radiofrequency ablation of liver tumors with the LeVeen probe: Is roll-off predictive of response?

PURPOSE: The LeVeen radiofrequency (RF) probe uses roll-off of electrical i mpedance as the endpoint for RF cautery of hepatic tumors. The purpose of t his study is to determine the relation of roll-off to local control of hepa tic tumors. MATERIALS AND METHODS: Twenty hepatic tumors, including 10 hepatomas and 10 metastases, were treated. Lesions ranged from 1.4 cm to 6.0 cm in diameter : 13 (57%) were smaller than 3.0 cm. Each lesion was ablated with use of th e LeVeen 15-gauge RF needle according to the manufacturer's protocol. Five patients underwent chemoembolization the day before. Patients were followed up with contrast-enhanced computed tomography or magnetic resonance imagin g at 1 month and every 3 months thereafter. RESULTS: Among the 20 lesions, roll-off was achieved at all burn locations in 11 (55%), no burn locations in eight (40%), and two of three burn locati ons in one (5%). Roll-off was observed in all patients who had undergone ch emoembolization the day before. Six local recurrences occurred, five after RF ablation without roll-off and one after RF ablation with roll-off. Accor ding to life-table analysis, the local recurrence rate at 6 months without roll-off was 43% and with roll-off was 15% (P =.024; OR = 8.3; 95% CI = 0.9 3-66). CONCLUSION: Roll-off is a significant predictor of local control after RF a blation. Strategies to enhance roll-off, such as concurrent embolization, m ay be important to optimize the therapeutic effect of this device.