Small Hepatocellular Carcinoma: Safety and Efficacy of Single High-Dose Percutaneous Acetic Acid Injection for Treatment

PURPOSE: To evaluate the safety and efficacy of single high-dose percutaneous acetic acid injection (PAI) for treatment of small (<3-cm-diameter) hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Eighteen patients with HCC (22 nodules; diameter range, 1.5–3.0 cm) underwent single PAI. With ultrasonographic or computed tomographic (CT) guidance, 4–11 mL of 50% acetic acid was slowly injected into the center of the nodule through a skinny multiple-side-hole needle. Follow-up was performed with helical contrast material–enhanced CT. Complications of high-dose PAI were recorded. RESULTS: Seventeen nodules showed no local recurrence (follow-up, 6–29 months) after single PAI. At a mean follow-up of 15.6 months, mean tumor diameter was 2.1 cm and mean injected volume was 6.4 mL. Four nodules showed residual tumor (mean tumor diameter, 2.6 cm; mean injected volume, 5.8 mL). The mean ratio of injected to estimated volume of acetic acid was 1.21 in cases of successful single PAI and 0.72 in cases of local recu...