DOI QR코드

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3D CACT-assisted Radiofrequency Ablation Following Transarterial Chemoembolization for Hepatocellular Carcinoma: Early Experience

  • Jiao, De-Chao (Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University) ;
  • Han, Xin-Wei (Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University) ;
  • Wu, Gang (Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University) ;
  • Ren, Jian-Zhuang (Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University)
  • 발행 : 2015.12.03

초록

Background: To explored the value of 3D C-arm CT (CACT) guidance system in performing radiofrequency ablation (RFA) following transarterial chemoembolizationon (TACE) for hepatocellular carcinomas. Materials and Methods: RFA of hepatocellular carcinomas (HCC) were performed on 15 patients (21 lesions) with the assistance of CACT guidance system. Technical success, procedure time, complications and patient radiation exposure were investigated. The puncture performance level was evaluated on a five-point scale (5-1: excellent-poor). Complete ablation rate was evaluated after two months follow-up using enhanced CT scans. Results: The technical success rate of RFA procedure under CACT navigation system was 100 %. Mean total procedure time was $24.24{\pm}6.53min$, resulting in a mean effective exposure dose of $15.4{\pm}5.1mSv$. The mean puncture performance level rated for CACT guided RFA procedure was $4.87{\pm}0.35$. Complete ablation (CA) was achieved in 20 (95.2%) of the treated 21 tumors after the first RFA session. None of patients developed intra-procedural complications. Conclusions: 3D CACT guidance system enables reliable and efficient needle positioning by providing real-time intraoperative guidance for performing RFA on HCCs.

키워드

참고문헌

  1. Ahmed M, Brace CL, Lee FT, et al (2011). Principles of and advances in percutaneous ablation. Radiology, 258, 351-9. https://doi.org/10.1148/radiol.10081634
  2. Bapst B,Lagadec M, Breguet R, et al (2015). Cone Beam Computed Tomography (CBCT) in the Field of Interventional Oncology of the Liver. Cardiovasc Intervent Radiol.
  3. Braak SJ, van Strijen MJ, van Es HW, et al (2011). Effective dose during needle interventions: cone-beam CT guidance compared with conventional CT guidance. J Vasc Interv Radiol, 22, 455-61. https://doi.org/10.1016/j.jvir.2011.02.011
  4. Busser WM, Braak SJ, Futterer JJ, et al (2013). Cone beam CT guidance provides superior accuracy for complex needle paths compared with CT guidance. Br J Radiol, 86, 20130310. https://doi.org/10.1259/bjr.20130310
  5. Cazzato RL, Buy X, Alberti N, et al (2015). Flat-panel conebeam CT-guided radiofrequency ablation of very small ($\leq$ 1.5 cm) liver tumors: technical note on a preliminary experience. Cardiovasc Interv Radiol, 38, 206-12. https://doi.org/10.1007/s00270-014-1019-6
  6. Cha D, Lee MW, Rhim H, et al (2013). Therapeutic efficacy and safety of percutaneous ethanol injection with or without combined radiofrequency ablation for hepatocellular carcinomas in high risk locations. Korean J Radiol, 14, 240-7. https://doi.org/10.3348/kjr.2013.14.2.240
  7. Cheung JY, Kim Y, Shim SS, et al (2011). Combined fluoroscopyand CT-guided transthoracic needle biopsy using a C-arm cone-beam CT system: comparison with fluoroscopy-guided biopsy. Korean J Radiol, 12, 89-96. https://doi.org/10.3348/kjr.2011.12.1.89
  8. Chiara F, Alessandra M, Federico F, et al (2014). C-arm cone-beam computed tomography needle path overlay for percutaneous biopsy of pulmonary nodules. Radiol Med, 19, 820-7.
  9. Cho YK, Rhim H, Noh S (2011). Radiofrequency ablation versus surgical resection as primary treatment of hepatocellular carcinoma meeting the Milan criteria: a systematic review. J Gastroenterol Hepatol, 26, 1354-60.
  10. Grasso RF, Cazzato RL, Luppi G, et al (2013). Percutaneous lung biopsies: performance of an optical CT-based navigation system with a low-dose protocol. Eur Radiol, 23, 3071-6. https://doi.org/10.1007/s00330-013-2932-9
  11. Gupta R, Cheung AC, Bartling SH, et al (2008). Flat-panel volume CT: fundamental principles, technology, and applications. Radiographics, 28, 2009-22. https://doi.org/10.1148/rg.287085004
  12. Hakime A, Deschamps F, De Carvalho EG, et al (2012). Electromagnetic-tracked biopsy under ultrasound guidance: preliminary results. Cardiovasc Intervent Radiol, 35, 898-905. https://doi.org/10.1007/s00270-011-0278-8
  13. Hol PK (2007). Ablative therapy of liver tumors. Acta Radiol, 48, 473. https://doi.org/10.1080/02841850701299700
  14. Jiao D, Qian L, Zhang Y, et al (2010). Microwave ablation treatment of liver cancer with 2,450-MHz cooled-shaft antenna: an experimental and clinical study. J Cancer Res Clin Oncol, 136, 1507-16. https://doi.org/10.1007/s00432-010-0808-9
  15. Jiao de C, Li TF, Han XW, et al (2014). Clinical applications of the C-arm cone-beam CT-based 3D needle guidance system in performing percutaneous transthoracic needle biopsy of pulmonary lesions. Diagn Interv Radiol, 20, 470-4. https://doi.org/10.5152/dir.2014.13463
  16. Kalender WA, Kyriakou Y (2017). Flat-detector computed tomography (FD-CT). Eur Radiol, 17, 2767-79.
  17. Lee IJ, Chung JW, Yin YH, et al (2014). Cone-beam CT hepatic arteriography in chemoembolization for hepatocellular carcinoma: angiographic image quality and its determining factors. J Vasc Interv Radiol, 25, 1369-79. https://doi.org/10.1016/j.jvir.2014.04.011
  18. Lee JY, Choi BI, Chung YE, et al (2012). Clinical value of CT/MR-US fusion imaging for radiofrequency ablation of hepatic nodules. Eur J Radiol, 81, 2281-9. https://doi.org/10.1016/j.ejrad.2011.08.013
  19. Mettler FA Jr, Huda W, Yoshizumi TT, et al (2008). Effective doses in radiology and diagnostic nuclear medicine: a catalog. Radiology, 248, 254-63. https://doi.org/10.1148/radiol.2481071451
  20. Morimoto M, Numata K, Kondo M, et al (2010). C-arm cone beam CT for hepatic tumor ablation under real-time 3D imaging. Am J Roentgenol, 194, 452-4. https://doi.org/10.2214/AJR.09.3514
  21. Park BK, Kim CK (2009). Complete ablation of a renal tumor abutting the inferior vena cava using a radiofrequency electrode as a lever: a case report. Acta Radiol, 50, 238-240. https://doi.org/10.1080/02841850802631975
  22. Racadio JM, Babic D, Homan R, et al (2007). Live 3D guidance in the interventional radiology suite. Am J Roentgenol, 189, 357-64. https://doi.org/10.2214/AJR.07.2469
  23. Rotolo N, Floridi C, Imperatori A, et al (2015). Comparison of cone-beam CT-guided and CT fluoroscopy-guided transthoracic needle biopsy of lung nodules. Eur Radiol, 2015.
  24. Schegerer AA, Lechel U, Ritter M, et al (2014). Dose and image quality of cone-beam computed tomography as compared with conventional multislice computed tomography in abdominal imaging. Invest Radiol, 49, 675-84. https://doi.org/10.1097/RLI.0000000000000069
  25. Sun YX, Cheng W, Han X, et al (2014). In vivo experimental study on the effects of fluid in increasing the efficiency of radiofrequency ablation. Asian Pac J Cancer Prev, 15, 5799-804. https://doi.org/10.7314/APJCP.2014.15.14.5799
  26. Wang CH, Wey KC, Mo LR, et al (2015). Current trends and recent advances in diagnosis, therapy, and prevention of hepatocellular carcinoma. Asian Pac J Cancer Prev, 16, 3595-604. https://doi.org/10.7314/APJCP.2015.16.9.3595
  27. Wang ZJ, Wang MQ, Duan Feng, et al (2013). Clinical application of transcatheter arterial chemoembolization combined with synchronous C-arm Cone-Beam CT guided radiofrequency ablation in treatment of large hepatocellular Carcinoma. Asian Pacific J Cancer Prev, 14, 1649-54. https://doi.org/10.7314/APJCP.2013.14.3.1649
  28. Xu C, Lv PH, Huang XE, et al (2015). Efficacy of transarterial chemoembolization combined with radiofrequency ablation in treatment of hepatocellular carcinoma. Asian Pac J Cancer Prev, 16, 6159-62. https://doi.org/10.7314/APJCP.2015.16.14.6159

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