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Published on: January 9, 2019
Transpulmonary radiofrequency ablation for hepatocellular carcinoma under real-time computed tomography-fluoroscopic
Takeharu Kato1, Takuji Yamagami, Tatsuya Hirota
1Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo, Kyoto 602-8566, Japan. tkato@koto.kpu-m.ac.jp
Background/Aims:
Radiofrequency ablation has been accepted as a safe treatment for unresectable malignant hepatic tumors. Tumors beneath the diaphragmatic dome may be difficult to visualize with ultrasonography. The aim of this study was to assess the use of transpulmonary radiofrequency ablation under real-time computed tomography-fluoroscopic guidance for hepatocellular carcinoma.
Methodology:
Twenty-four radiofrequency ablation treatments by means of a transpulmonary approach were performed in 22 patients under computed tomography-fluoroscopic guidance between December 2002 and April 2006. Every patient had a hepatocellular carcinoma less than 3cm in size beneath the diaphragmatic dome.
Results:
Transpulmonary radiofrequency ablation under real-time computed tomography-fluoroscopic guidance was successfully performed in every procedure. There was no local tumor recurrence in 22 cases (92%) on follow-up dynamic computed tomography performed an average of 8 months after radiofrequency ablation. The major complication was pneumothorax after 9 procedures (38%): pneumothorax in 6 patients had completely resolved on follow-up chest radiographs, and was treated with manual aspiration immediately after radiofrequency ablation in 3 patients, and no patients required chest-tube placement.
Conclusion:
Transpulmonary radiofrequency ablation under computed tomography-fluoroscopic guidance is a useful method for the accurate and safe ablation of hepatocellular carcinoma that is not detectable with ultrasonography.
