A new technique for localization of hepatic tumors that are poorly visible with CT fluoroscopy

The purpose of this study was to report a new technique for localization of hepatic tumors that are poorly visible with CT fluoroscopy. Forty-three hepatocellular carcinomas were not visible with CT fluoroscopy. A 22-gauge Chiba end-hole needle was inserted in the approximate location of a lesion estimated on the basis of anatomical landmarks demonstrated on both previous MR and CT images. We injected 3 ml of a mixture of nonionic contrast material and saline solution. Following the first injection, contrast solution filled the hepatic lesion in 29 of 43 cases. In 8 of 43 cases, contrast solution was distributed in the normal surrounding liver. In 7 of these 8 cases, repositioning allowed us to adjust the needle in the tumor. In the other 6 of 43 cases, contrast solution spread within capsule or pseudocapsule (pattern 3). In all 6 cases, repositioning allowed to adjust the needle in the tumor. This new technique allows an accurate localization of hepatic tumors that are poorly visible with CT fluoroscopy.