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01.07.2012 | Technical note

Oblique approach for CT-guided liver radiofrequency ablation using multiplanar reformation images in hepatocellular carcinoma

verfasst von: Seiji Kamei, Joe Matsuda, Makiyo Hagihara, Akira Kitagawa, Yuichiro Izumi, Eisuke Katsuda, Yukihiko Oshima, Shuji Ikeda, Junko Kimura, Toyohiro Ota, Toshiki Kawamura, Tsuneo Ishiguchi

Erschienen in: Japanese Journal of Radiology | Ausgabe 6/2012

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Abstract

Purpose

To evaluate the feasibility and safety of CT-guided radiofrequency (RF) ablation by caudal-cranial oblique insertion using multiplanar reformation (MPR) images for hepatocellular carcinomas (HCCs).

Materials and methods

Twenty-two HCCs in 19 patients that were difficult to demonstrate on ultrasound (mean tumor diameter was 17.5 mm) were treated with CT-guided RF ablation by caudal-cranial oblique insertion to avoid pneumothorax, using MPR images after transcatheter arterial chemoembolization. The insertion point and direction of insertion, avoiding aerated lung parenchyma, bones, large vessels, and intestine, were sought on the MPR images. Technical success was defined as complete eradication of tumor enhancement in the contrast-enhanced CT. Local tumor progression was defined by the appearance of enhanced tumor adjacent to the zone of ablation. The technical success rate, local tumor progression, and complications were investigated.

Results

The coronal plane was used for insertion in 18 tumors, the sagittal plane in 3 tumors, and the oblique plane in 1 tumor. RF electrode placement was successful and complete necrosis was obtained in all cases. During the mean follow-up period of 38.0 months, local tumor progression was not detected in any of the patients. There were no major complications, including pneumothorax.

Conclusion

CT-guided RF ablation by caudal-cranial oblique insertion using MPR images is a feasible and safe therapeutic option.

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Titel: Oblique approach for CT-guided liver radiofrequency ablation using multiplanar reformation images in hepatocellular carcinoma
verfasst von: Seiji Kamei
Joe Matsuda
Makiyo Hagihara
Akira Kitagawa
Yuichiro Izumi
Eisuke Katsuda
Yukihiko Oshima
Shuji Ikeda
Junko Kimura
Toyohiro Ota
Toshiki Kawamura
Tsuneo Ishiguchi
Publikationsdatum: 01.07.2012
Verlag: Springer Japan
Erschienen in: Japanese Journal of Radiology / Ausgabe 6/2012
Print ISSN: 1867-1071
Elektronische ISSN: 1867-108X
DOI: https://doi.org/10.1007/s11604-012-0074-7

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Oblique approach for CT-guided liver radiofrequency ablation using multiplanar reformation images in hepatocellular carcinoma