Percutaneous ablation of obscure hypovascular liver tumours in challenging locations using arterial CT-portography guidance.
Diagn Interv Imaging
; 101(11): 707-713, 2020 Nov.
Article
en En
| MEDLINE
| ID: mdl-33012694
ABSTRACT
PURPOSE:
The purpose of this study was to evaluate the feasibility, safety and efficacy of percutaneous ablation (PA) of obscure hypovascular liver tumors in challenging locations using arterial CT-portography (ACP) guidance. MATERIALS ANDMETHODS:
A total of 26 patients with a total of 28 obscure, hypovascular malignant liver tumors were included. There were 18 men and 6 women with a mean age of 58±14 (SD) years (range 37-75 years). The tumors had a mean diameter of 14±10 (SD) mm (range 7-24mm) and were intrahepatic cholangiocarcinoma (4/28; 14%), liver metastases from colon cancer (18/28; 64%), corticosurrenaloma (3/28; 11%) or liver metastases from breast cancer (3/28; 11%). All tumors were in challenging locations including subcapsular (14/28; 50%), liver dome (9/28; 32%) or perihilar (5/28; 18%) locations. A total of 28 PA (12 radiofrequency ablations, 11 microwave ablations and 5 irreversible electroporations) procedures were performed under ACP guidance.RESULTS:
A total of 67 needles [mean 2.5±1.5 (SD); range 1-5] were inserted under ACP guidance, with a 100% technical success rate for PA. Median total effective dose was 26.5 mSv (IQR 19.1, 32.2 mSv). Two complications were encountered (pneumothorax; one abscess both with full recovery), yielding a complication rate of 7%. No significant change in mean creatinine clearance was observed (80.5mL/min at baseline and 85.3mL/min at day 7; P=0.8). Post-treatment evaluation of the ablation zone was overestimated on ACP compared with conventional CT examination in 3/28 tumors (11%). After a median follow-up of 20 months (range 12-35 months), local tumor progression was observed in 2/28 tumours (7%).CONCLUSION:
ACP guidance is feasible and allows safe and effective PA of obscure hypo-attenuating liver tumors in challenging locations without damaging the renal function and with acceptable radiation exposure. Post-treatment assessment should be performed using conventional CT or MRI to avoid size overestimation of the ablation zone.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Neoplasias de los Conductos Biliares
/
Ablación por Catéter
/
Carcinoma Hepatocelular
/
Neoplasias Hepáticas
Tipo de estudio:
Guideline
Límite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Diagn Interv Imaging
Año:
2020
Tipo del documento:
Article
País de afiliación:
Francia