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Fig 1.

Flowchart of the study population enrollment.

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Table 1.

Baseline characteristics of the study population.

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Fig 2.

Diagram of the “no-tumor-touch” technique to ablate a 1.5 cm sized HCC.

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Fig 3.

Photographs of a separable cluster electrode (Octopus®, STARmed) composed of three internally-cooled electrodes that can be incorporated as (A) one cluster electrode with a large shaft, or separated as (B) three individual applicators with small handles.

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Table 2.

Differences between separable cluster electrodes and other electrodes.

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Fig 4.

A representative case showing the usefulness of a separable cluster electrode in ablating a large volume at one time.

(A) Axial CT image taken prior to RFA demonstrates a 3.4 cm sized, hypervascular lesion in the right lobe of the liver (arrowheads). (B) Intra-procedural US images fused with pre-procedural CT images guide the tumor (arrowheads) targeting and monitoring. (C) Axial CT image acquired immediately after RFA shows the ablation zone (arrowheads) sufficiently covering the index tumor, measured as 6.0 cm in long diameter, including the safety margin. (D) Coronal CT image reconstructed from the immediate post-procedural CT scan also depicts the ablation zone (arrowheads) measured as 5.9 cm in its coronal long axis.

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Fig 5.

Kaplan-Meier curves showing cumulative (A) local tumor progression and (B) recurrence-free survival rates after switching RFA of HCC, in the separable cluster electrode group and multiple internally-cooled electrode groups (p = .401 and p = .881, respectively).

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