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Flat-Panel Cone-Beam Ct-Guided Radiofrequency Ablation of Very Small (≤1.5 cm) Liver Tumors: Technical Note on a Preliminary Experience

  • Technical Note
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Abstract

Purpose

The aim of the present study was to investigate the technical feasibility of flat-panel cone-beam CT (CBCT)-guided radiofrequency ablation (RFA) of very small (<1.5 cm) liver tumors.

Materials and Methods

Patients included were candidates for hepatic percutaneous RFA as they had single biopsy-proven hepatic tumors sized ≤1.5 cm and poorly defined on ultrasonography. Following apnea induction, unenhanced CBCT scans were acquired and used to deploy the RF electrode with the aid of a virtual navigation system. If the tumor was not clearly identified on the unenhanced CBCT scan, a right retrograde arterial femoral access was established to carry out hepatic angiography and localize the tumor. Patients’ lesions and procedural variables were recorded and analyzed.

Results

Three patients (2 male and 1 female), aged 68, 76, and 87 years were included; 3 lesions (2 hepato-cellular carcinoma and 1 metastasis from colorectal cancer) were treated. One patient required hepatic angiography. Cycles of apnea used to acquire CBCT images and to deploy the electrode lasted <120 s. Mean fluoroscopic time needed to deploy the electrode was 36.6 ± 5.7 min. Mean overall procedural time was 66.0 ± 22.9 min. No peri- or post-procedural complications were noted. No cases of incomplete ablation were noted at 1-month follow-up.

Conclusion

Percutaneous CBCT-guided liver RFA with or without arterial hepatic angiography is technically feasible.

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Acknowledgments

Roberto Luigi Cazzato would like to thank CIRSE Fundation for supporting him with an educational Grant allowing him to attend a fellowship at the Department of Radiology, Institut Bergonié, Bordeaux, France. Without the support of such Grant, the present paper would have not be possible.

Conflict of interest

Roberto Luigi Cazzato, Xavier Buy, Nicolas Alberti, Mariane Fonck, Rosario Francesco Grasso and Jean Palussiere declare they have no conflict of interest to disclose.

Statement of Informed Consent

Informed consent was obtained from all individual participants included in the study.

Statement of Human Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Authors and Affiliations

  1. Department of Radiology, Institut Bergonié 229 Cours de l’Argonne, 33000, Bordeaux, France

    Roberto Luigi Cazzato, Xavier Buy, Nicolas Alberti, Mariane Fonck & Jean Palussière

  2. Department of Radiology and Diagnostic Imaging, Università “Campus Bio-Medico di Roma”, Via Alvaro del Portillo 200, 00128, Rome, Italy

    Roberto Luigi Cazzato & Rosario Francesco Grasso

Authors
  1. Roberto Luigi Cazzato
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  2. Xavier Buy
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  3. Nicolas Alberti
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  4. Mariane Fonck
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  5. Rosario Francesco Grasso
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  6. Jean Palussière
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Corresponding author

Correspondence to Roberto Luigi Cazzato.

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Cazzato, R.L., Buy, X., Alberti, N. et al. Flat-Panel Cone-Beam Ct-Guided Radiofrequency Ablation of Very Small (≤1.5 cm) Liver Tumors: Technical Note on a Preliminary Experience. Cardiovasc Intervent Radiol 38, 206–212 (2015). https://doi.org/10.1007/s00270-014-1019-6

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  • DOI: https://doi.org/10.1007/s00270-014-1019-6

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