Transthoracic percutaneous ethanol injection into the liver

Area of Science:

• Interventional Radiology
• Hepatobiliary Imaging
• Minimally Invasive Procedures

Background:

• Percutaneous ethanol injection (PEI) is a common treatment for liver tumors.
• Current PEI methods often rely on ultrasound guidance.
• A novel transthoracic approach offers a potential alternative for accessing subphrenic liver lesions.

Purpose of the Study:

• To evaluate the feasibility and safety of a new transthoracic percutaneous ethanol injection (PEI) technique.
• To assess the delivery of ethanol to the subphrenic liver region in a rat model.
• To determine the short-term complications associated with this novel approach.

Main Methods:

• Fourteen normal rats underwent computed tomography (CT)-guided PEI.
• A fine needle was inserted through the thoracic cage and lung parenchyma into the liver.
• Ethanol was injected, followed by serial CT scans and post-mortem examination.

Main Results:

• The transthoracic PEI procedure was successfully performed in all rats.
• Minor transient complications, including pneumothorax and pulmonary hemorrhage, were observed but resolved spontaneously.
• No macroscopic changes were noted in the diaphragm or pleura at autopsy.

Conclusions:

• Percutaneous ethanol injection through the lower lung parenchyma is achievable and potentially safe in normal rats.
• This transthoracic approach could serve as a complementary method to ultrasound-guided PEI for subphrenic liver tumors.
• Further research in abnormal livers and human subjects is warranted to confirm safety and efficacy.