All RFA procedures were performed percutaneously under US guidance (LOGIQ E9 or LOGIQ E10, GE Healthcare) by five radiologists with at least three years of experience with RFA using a fusion imaging technique (volume navigation; GE Healthcare) [13 (link)]. The operators used various RFA systems (VIVA RFA System, STARmed; Jet-tip RFA System, RF Medical). An active-tip length-adjustable tip (Proteus RF Electrode; STARmed) or clustered separable electrodes (Octopus Electrode, STARmed) were used. For ICWT, one (Jet-tip, RF Medical) or two (Twin electrodes, RF Medical) electrodes were used [10 (link)].
The operators used the tumor puncturing or no-touch method based on their preference, tumor location, and tumor shape [4 (link)]. Tumor-puncturing RFA refers to conventional RFA in which the operator places one electrode across the center of the tumor or multiple electrodes at the periphery of the tumor. In no-touch RFA, the operator positions multiple electrodes outside the tumor [12 (link)]. The RF energy is then delivered by switching monopolar, switching bipolar, and/or combined modes [5 (link)8 (link)11 (link)].
The operators used the tumor puncturing or no-touch method based on their preference, tumor location, and tumor shape [4 (link)]. Tumor-puncturing RFA refers to conventional RFA in which the operator places one electrode across the center of the tumor or multiple electrodes at the periphery of the tumor. In no-touch RFA, the operator positions multiple electrodes outside the tumor [12 (link)]. The RF energy is then delivered by switching monopolar, switching bipolar, and/or combined modes [5 (link)8 (link)11 (link)].
