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Liver Hepatocellular carcinoma (HCC) and SECONDARY LIVER TU / METASTASES /

Indications for HIFU in primary liver cancer - hepatocellular carcinoma (HCC)


  • Histologically verified HCC
  • Assessment of inoperability after consultations with two independent liver surgeons
  • The tumor is visualized by ultrasound – it is focal form with clear boundaries
  • Possibility of radical therapy in the first stages of the disease. When the disease is advanced - local palliative treatment with HIFU can be applied
  • Combination of TAE + HIFU in cases with hypervascular infiltrative process
  • Application of HIFU in cases of multifocal hepatocellular cancer -with up to 4 nodular foci
  • The distance between the skin surface and the farthest margin of the tumor is not more than 12 cm
  • The acoustic path of the FUS is safe and without obstructions
  • Good general condition of the patient - > 70% by Karnofsky’ scale

Contraindications for HIFU in hepatocellular carcinoma:

  • Diffuse hepatocarcinoma
  • The tumor infiltrates more than 50% of the liver
  • Seriously decompensated liver function
  • A patient with cachexia and presence of distant metastases Infected liver foci
  • Focos hepáticos infectados
  • Class "C" by the scale of Child
  • Thrombosis / tumor emboli / of the vena cava inferior
  • Prothrombin time



  • Histologically verified malignancy
  • A contrast enhanced CT study or visualized with abdominal ultrasound liver foci
  • Liver lesions are inoperable with the conventional surgery ( infiltration into large vessels , multi- centric metastases etc.).
  • Assessment of inoperability after consultations with two independent liver surgeons
  • A signed written refusal of the patient for a conventional surgical operation
  • At least two courses of chemotherapy are applied according to the specifics of the underlying disease
  • Expected survival for more than 3 months

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.

    • the metastatic process is spread in more than 50% of the liver
    • More than 4 metastatic foci; larger than 5 cm or the total amount of their size is exceeding 10 cm
    • Obstructive jaundice
    • Platelets
    • prothrombin time below 50%
    • Leukocytes / WBC /> 3.5
    • Contraindications for general anesthesia