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CT-Guided Microwave Ablation of Liver Tumors in Anatomically Challenging Locations

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Abstract

Purpose

To assess the feasibility and outcome of microwave ablation (MWA) of hepatic tumors in anatomically challenging locations.

Materials and Methods

A total of 94 patients with 174 hepatic tumors referred for CT-guided MWA were included in this retrospective institutional review board-approved study. One hundred and twenty-five tumors (median size 17 mm, range 12–24 mm) with subcapsular location (n = 91) and/or in which a transpleural approach was applied (n = 53) were identified (group 1) and compared to tumors with a central intrahepatic location (group 2; n = 49, median size 19 mm, range 12–23 mm). Technical success, complications and local tumor progression (LTP) were evaluated. Risk factors were analyzed using univariate analysis, logistic regression and Kaplan–Meier curves (p < 0.05 deemed significant).

Results

Technical success was 100% in both groups. In group 1, complications occurred in n = 31 tumors (24.8%; pneumothorax n = 20; hematoma n = 11). Complications occurred significantly less often in group 2 (8.2%; n = 4 (hematoma); p = 0.011). There were no major complications. Transpleural approach and number of capsule punctures were identified as risk factors for complications (all p < 0.05). Median follow-up was 265 days. LTP was comparable between both groups (13.6 vs. 10.2%; p = 0.41). Use of hydrodissection was the only independent factor associated with LTP (p = 0.03, HR 3.29).

Conclusion

CT-guided hepatic MWA of subcapsular tumors and subdiaphragmatic tumors requiring a direct or transpleural approach is feasible with increased minor but not major complications. LTP did not differ significantly between both groups.

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Acknowledgement

This work was supported by a grant from the Deutsche Forschungsgemeinschaft (Grant Number RI2592/1-1).

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg Str. 1, 30625, Hannover, Germany

    Van Dai Vo Chieu, Thomas Werncke, Bennet Hensen, Frank Wacker & Kristina I. Ringe

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  1. Van Dai Vo Chieu
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  2. Thomas Werncke
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  3. Bennet Hensen
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  4. Frank Wacker
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  5. Kristina I. Ringe
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Correspondence to Kristina I. Ringe.

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The authors declare that they have no conflict of interest in relation to this work.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this retrospective study, informed patient consent was waived by the local institutional review board.

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Vo Chieu, V.D., Werncke, T., Hensen, B. et al. CT-Guided Microwave Ablation of Liver Tumors in Anatomically Challenging Locations. Cardiovasc Intervent Radiol 41, 1520–1529 (2018). https://doi.org/10.1007/s00270-018-2007-z

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  • DOI: https://doi.org/10.1007/s00270-018-2007-z

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