Cone Beam Computed Tomography Image Fusion with Cross Sectional Images for Percutaneous Renal Tumor Ablation: Preliminary Data
Purpose Percutaneous ablative treatments in the kidney are now standard options for local cancer therapy. Multimodality image guidance, combining two 3D image sets, may improve procedural images and interventional strategies. We aimed to assess the value of intra-procedural cone beam computed tomogr...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2023-03-01
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| Series: | Technology in Cancer Research & Treatment |
| Online Access: | https://doi.org/10.1177/15330338231154994 |
| _version_ | 1827976453950537728 |
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| author | Anna Maria Ierardi MD Aldo Carnevale MD Elvira Stellato MD Elisa De Lorenzis MD Licia Uccelli PhD Gianlorenzo Dionigi MD Melchiore Giganti MD Emanuele Montanari MD Gianpaolo Carrafiello MD |
| author_facet | Anna Maria Ierardi MD Aldo Carnevale MD Elvira Stellato MD Elisa De Lorenzis MD Licia Uccelli PhD Gianlorenzo Dionigi MD Melchiore Giganti MD Emanuele Montanari MD Gianpaolo Carrafiello MD |
| author_sort | Anna Maria Ierardi MD |
| collection | DOAJ |
| description | Purpose Percutaneous ablative treatments in the kidney are now standard options for local cancer therapy. Multimodality image guidance, combining two 3D image sets, may improve procedural images and interventional strategies. We aimed to assess the value of intra-procedural cone beam computed tomography (CBCT) with magnetic resonance (MR) or CT imaging fusion technique in the guidance of percutaneous microwave ablation (MWA) of renal neoplasms. Materials and methods Fifteen patients (eight males, seven females, median age 65 years, median lesion size 20 mm) underwent percutaneous MWA for 15 renal tumors. All the procedures were performed in a dedicated angiography room setting; CBCT ablation planning capabilities included multimodality image fusion. Preoperative contrast-enhanced CT was available in 12 patients, whereas magnetic resonance imaging in the remaining. All patients were considered inoperable due to comorbidities, advanced age, and/or refusal to undergo surgery. Exclusion criteria were: tumors visible at unenhanced CBCT, metastatic disease, and uncorrected coagulopathy. Technical success and technical effectiveness were calculated. Procedural time, complications and recurrences were registered. Results MWA under CBCT-guidance with fusion technique was technically successful in 14 out of 15 cases (93%). The median procedural time was 45 min. No procedure-related complications were reported. No enhancing tissue was visualized in the area of ablation at 1-month follow-up. All 15 cases were recurrence-free at last follow-up assessment (median follow-up of 12 months); no cancer-specific deaths were registered. Conclusion CBCT-CT/MR image fusion is technically feasible and safe in achieving correct targeting and complete ablation of renal lesions. This approach bears the potential to overcome most of the limitations of unenhanced CBCT guidance alone; larger series are needed to validate this technique. |
| first_indexed | 2024-04-09T20:35:42Z |
| format | Article |
| id | doaj.art-6dad39c29298474896f733de115ab9b3 |
| institution | Directory Open Access Journal |
| issn | 1533-0338 |
| language | English |
| last_indexed | 2024-04-09T20:35:42Z |
| publishDate | 2023-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Technology in Cancer Research & Treatment |
| spelling | doaj.art-6dad39c29298474896f733de115ab9b32023-03-30T10:03:39ZengSAGE PublishingTechnology in Cancer Research & Treatment1533-03382023-03-012210.1177/15330338231154994Cone Beam Computed Tomography Image Fusion with Cross Sectional Images for Percutaneous Renal Tumor Ablation: Preliminary DataAnna Maria Ierardi MD0Aldo Carnevale MD1Elvira Stellato MD2Elisa De Lorenzis MD3Licia Uccelli PhD4Gianlorenzo Dionigi MD5Melchiore Giganti MD6Emanuele Montanari MD7Gianpaolo Carrafiello MD8 Radiology Unit, , Milan, Italy Radiology Unit, Department of Translational Medicine, , Ferrara, Italy Postgraduate School of Radiodiagnostics, , Milan, Italy Urology Unit, , Milan, Italy Radiology Unit, Department of Translational Medicine, , Ferrara, Italy Department of Pathophysiology and Transplantation, , Milan, Italy Radiology Unit, Department of Translational Medicine, , Ferrara, Italy Department of Clinical Sciences and Community Health, , Milan, Italy Department of Health Sciences, , Milan, ItalyPurpose Percutaneous ablative treatments in the kidney are now standard options for local cancer therapy. Multimodality image guidance, combining two 3D image sets, may improve procedural images and interventional strategies. We aimed to assess the value of intra-procedural cone beam computed tomography (CBCT) with magnetic resonance (MR) or CT imaging fusion technique in the guidance of percutaneous microwave ablation (MWA) of renal neoplasms. Materials and methods Fifteen patients (eight males, seven females, median age 65 years, median lesion size 20 mm) underwent percutaneous MWA for 15 renal tumors. All the procedures were performed in a dedicated angiography room setting; CBCT ablation planning capabilities included multimodality image fusion. Preoperative contrast-enhanced CT was available in 12 patients, whereas magnetic resonance imaging in the remaining. All patients were considered inoperable due to comorbidities, advanced age, and/or refusal to undergo surgery. Exclusion criteria were: tumors visible at unenhanced CBCT, metastatic disease, and uncorrected coagulopathy. Technical success and technical effectiveness were calculated. Procedural time, complications and recurrences were registered. Results MWA under CBCT-guidance with fusion technique was technically successful in 14 out of 15 cases (93%). The median procedural time was 45 min. No procedure-related complications were reported. No enhancing tissue was visualized in the area of ablation at 1-month follow-up. All 15 cases were recurrence-free at last follow-up assessment (median follow-up of 12 months); no cancer-specific deaths were registered. Conclusion CBCT-CT/MR image fusion is technically feasible and safe in achieving correct targeting and complete ablation of renal lesions. This approach bears the potential to overcome most of the limitations of unenhanced CBCT guidance alone; larger series are needed to validate this technique.https://doi.org/10.1177/15330338231154994 |
| spellingShingle | Anna Maria Ierardi MD Aldo Carnevale MD Elvira Stellato MD Elisa De Lorenzis MD Licia Uccelli PhD Gianlorenzo Dionigi MD Melchiore Giganti MD Emanuele Montanari MD Gianpaolo Carrafiello MD Cone Beam Computed Tomography Image Fusion with Cross Sectional Images for Percutaneous Renal Tumor Ablation: Preliminary Data Technology in Cancer Research & Treatment |
| title | Cone Beam Computed Tomography Image Fusion with Cross Sectional Images for Percutaneous Renal Tumor Ablation: Preliminary Data |
| title_full | Cone Beam Computed Tomography Image Fusion with Cross Sectional Images for Percutaneous Renal Tumor Ablation: Preliminary Data |
| title_fullStr | Cone Beam Computed Tomography Image Fusion with Cross Sectional Images for Percutaneous Renal Tumor Ablation: Preliminary Data |
| title_full_unstemmed | Cone Beam Computed Tomography Image Fusion with Cross Sectional Images for Percutaneous Renal Tumor Ablation: Preliminary Data |
| title_short | Cone Beam Computed Tomography Image Fusion with Cross Sectional Images for Percutaneous Renal Tumor Ablation: Preliminary Data |
| title_sort | cone beam computed tomography image fusion with cross sectional images for percutaneous renal tumor ablation preliminary data |
| url | https://doi.org/10.1177/15330338231154994 |
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