Role of percutaneous ethanol ablation in malignant liver tumours

Purpose: To study the effectiveness of image-guided percutaneous ethanol injection (PEI) to ablate malignant hepatic lesions. Methods: It was a hospital based prospective study. Study included 15 patients (8 men, 7 women); aged 40-75 years (mean age 58.3 years); involving 4 hepatocellular carcinoma (HCC) (ranging from 2.8 cm-8.0 cm in diameter) and 18 liver metastases (ranging from 0.78 cm-4.5 cm in diameter). Forty eight sessions (18 sessions for 3 HCCs and 30 for 11 liver metastases) using 99.9% ethanol injection were done under image guidance to treat 21 tumours in 14 patients. Under local anaesthesia, absolute ethanol (99.9%) was instilled into the tumour via 22 gauge spinal needle. Triple phased Contrast enhanced computed tomography (CECT) was used in all the cases to assess the treatment response. Results: The 3 patients having solitary HCC tumours measuring 2.8 cm, 6.5 cm and 8 cm were assigned into complete response, partial response and progressive disease categories respectively after PEI. Treatment response was not assessed in 1 patient. Among 11 liver metastases patients; complete response, partial response, stable disease and progressive disease was assigned in 5 (45.5%), 1 (6.6%), 2 (18.1%) and 3 (27.2%) patients respectively. Conclusions: PEI is a safe and effective technique for treating smaller liver neoplasms and less than 3 lesions for each patient as per BCLC criteria.