Indications for HIFU in primary liver cancer - hepatocellular carcinoma (HCC):
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Histologically verified HCC
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Assessment of inoperability after consultations with two independent liver surgeons
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The tumor is visualized by ultrasound – it is focal form with clear boundaries
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Possibility of radical therapy in the first stages of the disease. When the disease is advanced - local palliative treatment with HIFU can be applied
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Combination of TAE + HIFU in cases with hypervascular infiltrative process
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Application of HIFU in cases of multifocal hepatocellular cancer - with up to 4 nodular foci
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The distance between the skin surface and the farthest margin of the tumor is not more than 12 cm
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The acoustic path of the FUS is safe and without obstructions
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Good general condition of the patient - > 70% by Karnofsky’ scale
Contraindications for HIFU in hepatocellular carcinoma:
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Diffuse hepatocarcinoma
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The tumor infiltrates more than 50% of the liver
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Seriously decompensated liver function
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A patient with cachexia and presence of distant metastases Infected liver foci
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Class "C" by the scale of Child
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Thrombosis / tumor emboli / of the vena cava inferior
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Prothrombin time <50%
INDICATIONS FOR HIFU IN SECONDARY LIVER TU / METASTASES / :
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Histologically verified malignancy
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A contrast enhanced CT study or visualized with abdominal ultrasound liver foci
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Liver lesions are inoperable with the conventional surgery ( infiltration into large vessels , multi- centric metastases etc.).
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Assessment of inoperability after consultations with two independent liver surgeons
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A signed written refusal of the patient for a conventional surgical operation
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At least two courses of chemotherapy are applied according to the specifics of the underlying disease
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Expected survival for more than 3 months
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HIFU ablation is an alternative method for the palliative treatment of liver metastases which may be applied under the following conditions : the number of metastases in the liver is not more than 3-4 , they are not larger in size than 5 cm , the total amount does not exceed 10 cm
CONTRAINDICATIONS FOR HIFU ABLATION OF LIVER METASTASES :
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the metastatic process is spread in more than 50% of the liver
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More than 4 metastatic foci; larger than 5 cm or the total amount of their size is exceeding 10 cm
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Obstructive jaundice
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Platelets <50,000 / UL
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prothrombin time below 50%
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Leukocytes / WBC /> 3.5
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Contraindications for general anesthesia