Electromagnetic navigation system combined with High-Frequency-Jet-Ventilation for CT-guided hepatic ablation of small US-Undetectable and difficult to access lesions.

Détails

ID Serval
serval:BIB_D011FB3C57F4
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Electromagnetic navigation system combined with High-Frequency-Jet-Ventilation for CT-guided hepatic ablation of small US-Undetectable and difficult to access lesions.
Périodique
International journal of hyperthermia
Auteur(s)
Volpi S., Tsoumakidou G., Loriaud A., Hocquelet A., Duran R., Denys A.
ISSN
1464-5157 (Electronic)
ISSN-L
0265-6736
Statut éditorial
Publié
Date de publication
2019
Peer-reviewed
Oui
Volume
36
Numéro
1
Pages
1051-1057
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
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.
Mots-clé
Aged, Aged, 80 and over, Carcinoma, Hepatocellular/diagnosis, Carcinoma, Hepatocellular/surgery, Electromagnetic Phenomena, Female, High-Frequency Jet Ventilation/methods, Humans, Liver Neoplasms/diagnostic imaging, Liver Neoplasms/surgery, Male, Middle Aged, Prospective Studies, Tomography, X-Ray Computed/methods, Liver tumors, ablation techniques, electromagnetic navigation, high-frequency jet ventilation, image guidance
Pubmed
Web of science
Open Access
Oui
Création de la notice
21/10/2019 15:50
Dernière modification de la notice
25/07/2020 5:26
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