Electromagnetic navigation system combined with High-Frequency-Jet-Ventilation for CT-guided hepatic ablation of small US-Undetectable and difficult to access lesions
Objectives: To report the feasibility and efficacy of percutaneous ablation of small hepatic malignant tumors that are invisible on ultrasound and inaccessible using in-plane CT guidance, using a combination of high-frequency jet-ventilation (HFJV) and electromagnetic (EM) needle tracking. Methods:...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2019-01-01
|
| Series: | International Journal of Hyperthermia |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/02656736.2019.1671612 |
| _version_ | 1819241894423560192 |
|---|---|
| author | Stephanie Volpi Georgia Tsoumakidou Amélie Loriaud Arnaud Hocquelet Rafael Duran Alban Denys |
| author_facet | Stephanie Volpi Georgia Tsoumakidou Amélie Loriaud Arnaud Hocquelet Rafael Duran Alban Denys |
| author_sort | Stephanie Volpi |
| collection | DOAJ |
| description | Objectives: To report the feasibility and efficacy of percutaneous ablation of small hepatic malignant tumors that are invisible on ultrasound and inaccessible using in-plane CT guidance, using a combination of high-frequency jet-ventilation (HFJV) and electromagnetic (EM) needle tracking. Methods: This study reviewed 27 percutaneous ablations of small hepatic tumors (<2 cm) performed using EM navigation-based probe placement and HFJV. All lesions were invisible on ultrasound and difficult to reach on CT requiring a double-oblique approach. The primary outcome was technical efficacy, defined as complete lesion coverage, and evaluated on contrast enhanced MRI after 3 and 6 months. Needle placement accuracy, the number of control CT acquisitions, procedure time, complications and radiation doses were assessed. Results: Twenty-one patients with 27 treated lesions (14 hepatocellular carcinomas and 13 metastases) were included in this study. Mean tumor size was 12 ± 5.7 mm. Thirty-three percent of the lesions were located on the hepatic dome. Complete ablation was obtained in 100% at the 3- and 6-month MRI follow-up. The ablation probe was correctly placed on the first pass in 96%, with a mean path-to-tumor angle of 7 ± 4 degrees and a mean tip-to-tumor distance of 22 ± 19mm. A readjustment for additional overlapping application resulted in complete treatment in 4 patients. Needle placement took a mean 23 ± 12 min with mean radiation doses of 558 mGy*cm. No major complications were reported. Conclusion: Percutaneous liver ablation of lesions that cannot be seen on US and requiring out-of-plane CT access can be successfully and safely treated using electromagnetic-based navigation and jet-ventilation. |
| first_indexed | 2024-12-23T14:31:10Z |
| format | Article |
| id | doaj.art-85fb697c2bc74746a6c1e77afae1b65d |
| institution | Directory Open Access Journal |
| issn | 0265-6736 1464-5157 |
| language | English |
| last_indexed | 2024-12-23T14:31:10Z |
| publishDate | 2019-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | International Journal of Hyperthermia |
| spelling | doaj.art-85fb697c2bc74746a6c1e77afae1b65d2022-12-21T17:43:30ZengTaylor & Francis GroupInternational Journal of Hyperthermia0265-67361464-51572019-01-013611050105610.1080/02656736.2019.16716121671612Electromagnetic navigation system combined with High-Frequency-Jet-Ventilation for CT-guided hepatic ablation of small US-Undetectable and difficult to access lesionsStephanie Volpi0Georgia Tsoumakidou1Amélie Loriaud2Arnaud Hocquelet3Rafael Duran4Alban Denys5Interventional Radiology UnitInterventional Radiology UnitInterventional Radiology UnitInterventional Radiology UnitInterventional Radiology UnitInterventional Radiology UnitObjectives: To report the feasibility and efficacy of percutaneous ablation of small hepatic malignant tumors that are invisible on ultrasound and inaccessible using in-plane CT guidance, using a combination of high-frequency jet-ventilation (HFJV) and electromagnetic (EM) needle tracking. Methods: This study reviewed 27 percutaneous ablations of small hepatic tumors (<2 cm) performed using EM navigation-based probe placement and HFJV. All lesions were invisible on ultrasound and difficult to reach on CT requiring a double-oblique approach. The primary outcome was technical efficacy, defined as complete lesion coverage, and evaluated on contrast enhanced MRI after 3 and 6 months. Needle placement accuracy, the number of control CT acquisitions, procedure time, complications and radiation doses were assessed. Results: Twenty-one patients with 27 treated lesions (14 hepatocellular carcinomas and 13 metastases) were included in this study. Mean tumor size was 12 ± 5.7 mm. Thirty-three percent of the lesions were located on the hepatic dome. Complete ablation was obtained in 100% at the 3- and 6-month MRI follow-up. The ablation probe was correctly placed on the first pass in 96%, with a mean path-to-tumor angle of 7 ± 4 degrees and a mean tip-to-tumor distance of 22 ± 19mm. A readjustment for additional overlapping application resulted in complete treatment in 4 patients. Needle placement took a mean 23 ± 12 min with mean radiation doses of 558 mGy*cm. No major complications were reported. Conclusion: Percutaneous liver ablation of lesions that cannot be seen on US and requiring out-of-plane CT access can be successfully and safely treated using electromagnetic-based navigation and jet-ventilation.http://dx.doi.org/10.1080/02656736.2019.1671612liver tumorsablation techniquesimage guidanceelectromagnetic navigationhigh-frequency jet ventilation |
| spellingShingle | Stephanie Volpi Georgia Tsoumakidou Amélie Loriaud Arnaud Hocquelet Rafael Duran Alban Denys Electromagnetic navigation system combined with High-Frequency-Jet-Ventilation for CT-guided hepatic ablation of small US-Undetectable and difficult to access lesions International Journal of Hyperthermia liver tumors ablation techniques image guidance electromagnetic navigation high-frequency jet ventilation |
| title | Electromagnetic navigation system combined with High-Frequency-Jet-Ventilation for CT-guided hepatic ablation of small US-Undetectable and difficult to access lesions |
| title_full | Electromagnetic navigation system combined with High-Frequency-Jet-Ventilation for CT-guided hepatic ablation of small US-Undetectable and difficult to access lesions |
| title_fullStr | Electromagnetic navigation system combined with High-Frequency-Jet-Ventilation for CT-guided hepatic ablation of small US-Undetectable and difficult to access lesions |
| title_full_unstemmed | Electromagnetic navigation system combined with High-Frequency-Jet-Ventilation for CT-guided hepatic ablation of small US-Undetectable and difficult to access lesions |
| title_short | Electromagnetic navigation system combined with High-Frequency-Jet-Ventilation for CT-guided hepatic ablation of small US-Undetectable and difficult to access lesions |
| title_sort | electromagnetic navigation system combined with high frequency jet ventilation for ct guided hepatic ablation of small us undetectable and difficult to access lesions |
| topic | liver tumors ablation techniques image guidance electromagnetic navigation high-frequency jet ventilation |
| url | http://dx.doi.org/10.1080/02656736.2019.1671612 |
| work_keys_str_mv | AT stephanievolpi electromagneticnavigationsystemcombinedwithhighfrequencyjetventilationforctguidedhepaticablationofsmallusundetectableanddifficulttoaccesslesions AT georgiatsoumakidou electromagneticnavigationsystemcombinedwithhighfrequencyjetventilationforctguidedhepaticablationofsmallusundetectableanddifficulttoaccesslesions AT amelieloriaud electromagneticnavigationsystemcombinedwithhighfrequencyjetventilationforctguidedhepaticablationofsmallusundetectableanddifficulttoaccesslesions AT arnaudhocquelet electromagneticnavigationsystemcombinedwithhighfrequencyjetventilationforctguidedhepaticablationofsmallusundetectableanddifficulttoaccesslesions AT rafaelduran electromagneticnavigationsystemcombinedwithhighfrequencyjetventilationforctguidedhepaticablationofsmallusundetectableanddifficulttoaccesslesions AT albandenys electromagneticnavigationsystemcombinedwithhighfrequencyjetventilationforctguidedhepaticablationofsmallusundetectableanddifficulttoaccesslesions |