الفهرس 
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Abstract
Hepatocellular carcinoma (HCC) is the sixth most common type of cancer and the third leading cause of cancer-related death. Local ablation modalities emerged as the best therapeutic option for nonsurgical patients with early HCC. Radiofrequency ablation (RFA) technique, first described in 1993 showed superior results in terms of prevention of recurrence and improvement of tumor necrosis in comparison to percutaneous ethanol injection. In recent years, the potential role of microwave ablation (MWA) has become increasingly apparent, micro-wave device and antenna had been greatly improved. The present study aimed at comparing the effectiveness of radio-frequency (RFA) ablation and percutaneous microwave ablation (MWA) for treatment of small hepatocellular carcinoma (HCC). For this purpose 50 patients with small HCC nodules less than 3.5 were enrolled, randomly classified into 2 equal groups: RFA group:- 25 patients who will be treated by radiofrequency ablation. MWA group:- 25 patients who will be treated by microwave ablation. Triphasic CT done before ablation show that ; of the 25 patients treated with RF ablation, 23 had a solitary nodule, one had two nodules, and one had three nodules; thus, a total of 28 nodules were treated in these patients. Of the 25 patients treated with MWA, 23 had a solitary nodule, 2 had two nodules ; thus, a total of 27 nodules were treated in these patients. The maximum diameter of the nodules treated with RFA ranges 2-3.5cm with mean diameter equals 3.0±0.39cm, in this group we had we had 17 nodules (58.6% of nodules) measures 2 -3 cm and 11nodules (41.4% of nodules) measures 3-3.5cm. The maximum diameter of the nodules treated with MWA ranges 2.4-3.5 with mean diameter equals 3.2±0. 35, in this group we had 12 nodules (44.4 % of nodules) measures 2 -3 cm and 15 nodules (46.6% of nodules) measures 3-3.5cm. In the MWA group of 25 patients, one to three microwave coagulation sessions per nodule were performed, and a total of 32 sessions were performed in the 27 nodules. A single treatment session was performed in 23 (85.2%) of the 27 nodules, two sessions were performed in 3 nodules (11.1%), three sessions were performed in 1 nodules (3.7%). In the RFA group of 25 patients, one to three radiofrequency ablation sessions per nodule were performed, and a total of 35 sessions were performed in the 28 nodules. A single treatment session was performed in 24 (82.8%) of the 28 nodules, two sessions were performed in 4 (13.8%) nodules, three sessions were performed in 1 (3.4%) nodule. The mean time required for MWA session was 7.1 +/- 2.4 minutes which was significantly shorter than that required for an RF ablation session which was 22.9+/- 7.9 minutes. The triphasic CT done 2 weeks afters the first treatment sessions revealed a complete response achieved in 85.2% (23/27) of lesions treated with MWA and in 82.8% (23/28) of lesions treated with RFA ablation while partial response was achieved in 14.8% (4/27) of lesions treated with MWA and in 17.2% (5/28) of lesions treated with RFA ablation .The patient those have partial response on triphasic done 2 weeks after the first session had another ablation session till complete response . The patients in whom complete response was achieved (24 patient in each group) they were follow up by tripahsic CT after 2 and 6 month to asses for local tumor progression and /or distant recurrence. At 2 months triphasic CT none of them in each group has local tumor progression or distant recurrence. At 6 months triphasic CT; in the RFA group 4 patients (16%) had LTP and 2 (8%) patients had DR and another 2 patients had LTP and DR . In the MWA group 2 patients (8%) had LTP and 2 patients (8%) had DR and 1 patient (4%) LTP and DR. In summary, we concluded that radiofrequency and microwave ablations led to safe and equivalent ablation and survival rates. Both ablative techniques are a good replacement to surgical interference for patients who are not fit for surgical resection.