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CT-guided transthoracic percutaneous ethanol injection for hepatocellular carcinoma not detectable with US
Toshiya Shibata1, Yuji Iimuro, Yuzo Yamamoto
1Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Shogoin, Sakyoku, Kyoto 606-8507, Japan.
Insights
Computed tomography (CT)-guided percutaneous ethanol injection (PEI) is safe and effective for treating hepatocellular carcinoma (HCC) nodules undetectable by ultrasonography (US). This minimally invasive approach shows promise for managing difficult-to-detect liver cancers.
Area of Science:
- Hepatobiliary Medicine
- Interventional Radiology
- Oncology
Background:
- Hepatocellular carcinoma (HCC) is a primary liver cancer with increasing incidence.
- Early detection of HCC is crucial for effective treatment, but some nodules are not visible with standard ultrasonography (US).
- Computed tomography (CT) offers improved visualization for detecting small or subtle HCC nodules.
Purpose of the Study:
- To assess the safety and efficacy of CT-guided percutaneous ethanol injection (PEI) for treating HCC.
- To evaluate the outcomes for patients with HCC nodules not detectable by US.
Main Methods:
- A retrospective study involving 51 patients with 57 HCC nodules undetectable by US.
- CT-guided transthoracic PEI was performed between April 1994 and January 2001.
- Evaluation of complications, treatment effectiveness, and patient prognosis.
Main Results:
- Seventy-one PEI sessions were conducted for 57 nodules.
- Complications included pneumothorax (30%), pleural effusion (6%), and hemoptysis (4%).
- Tumor necrosis was observed in 89% of nodules; local recurrence occurred in 12%.
Conclusions:
- CT-guided transthoracic PEI is a relatively safe and effective treatment modality.
- This technique is valuable for managing HCC nodules that are not visible with ultrasonography.
- Further research may optimize PEI protocols for improved HCC patient outcomes.
Purpose:
To evaluate the safety and effectiveness of computed tomography (CT)-guided percutaneous ethanol injection (PEI) for the treatment of hepatocellular carcinoma (HCC) not detectable with ultrasonography (US).
Materials And Methods:
Between April 1994 and January 2001, 51 patients with 57 HCC nodules not detectable with US underwent CT-guided transthoracic PEI. Complications associated with the transthoracic approach, effectiveness of transthoracic PEI, and prognosis of the patients were evaluated.
Results:
Seventy-one PEI sessions were performed for 57 nodules. Complications included pneumothorax in 21 sessions (30%) for 19 nodules (33%), moderate pleural effusion in four sessions (6%) for four nodules (7%), and hemoptysis in three sessions (4%) for two nodules (4%). A chest tube was required for pneumothorax in five sessions (7%) for five nodules (9%), and pleural effusion drainage was performed in two sessions (3%) for two nodules (4%). Apparent tumor necrosis was noted at CT in 51 nodules (89%). During follow-up (range, 3 months to 5(1/2) years; mean, 29 months +/- 18 [SD]), local recurrence was seen in seven nodules (12%), three of which received repeat treatment with transthoracic PEI. Twenty-six patients survived, and 25 patients died of multiple tumors, hepatic failure, or rupture of esophageal varices.
Conclusion:
Transthoracic PEI seems to be relatively safe and effective for the treatment of HCC not detectable with US.