Aims and objectives
The aim of this work was to evaluatethe technical success of thermal ablations of liver malignancies achieved with cone-beam CT (CBCT) performed immediately after the end of ablation with the evaluation achieved with conventional 24-hr post-ablation CT.
Methods and materials
In angiographic suite equipped with a biplane equipment with CBCT (Siemens Artis Zee Biplane,
Erlangen,
Germany),
between September 2015 and July 2018,
185 patients with 237 liver malignancies (142 hepatocellular carcinoma (HCC) and 95 metastases from colonrectal (85) and breast (10) carcinoma),
(0.7 – 4.7 cm size range,
mean 2.1 cm) underwent percutaneous ultrasound-guided microwave ablation (Amica,
HS Hospital Service,
Aprilia,
Italy) under local anesthesia and neuroleptoanalgesia. Immediately at the end of the procedure,
contrast-enhanced CBCT was performed,
administering a mean of 120 ml of...
Results
CBCT scans were technically adequate for 198/237 (83.5%) tumors,
while,
for the remaining 39/237 (16.5%) cases,
artifacts related to patients’ movements or breathing caused by local pain or partial awakening made CBCT scans not readable. In the group of 198 tumors with technically adequate CBCT exams,
technical success was considered achieved in 191/198 (96.5%) CBCT scans (with re-treatment of the unablated tumoral area immediately performed for the 7 malignancies in which residual viable tumor was demonstrated) and in 181/198 (91.4%) 24-hr post-ablation CT scans. In...
Conclusion
Immediate post-ablation CBCT,
when technically adequate,
provides technical success assessment with accuracy comparable with that of 24-hr post-ablation CT,
with the additional advantages to allow re-treatment of tumoral areas incompletely ablated during the same session and to detect complications (mostly perihepatic and intrahepatic bleedings) in early phase allowing immediate treatment.
References
Real-Time 3D Virtual Target Fluoroscopic Display for Challenging Hepatocellular Carcinoma Ablations Using Cone Beam CT
Technol Cancer Res Treat.2018 Jan 1;17