Aukje A J M van Tilborg1, Hester J Scheffer2, Karin Nielsen3, Jan Hein T M van Waesberghe2, Emile F Comans2, C van Kuijk2, Petrousjka M van den Tol3, Martijn R Meijerink2. 1. Department of Radiology and Nuclear Medicine, VU University Medical Center, De Boelelaan 1117, 1081HV Amsterdam, the Netherlands. Electronic address: a.vantilborg@vumc.nl. 2. Department of Radiology and Nuclear Medicine, VU University Medical Center, De Boelelaan 1117, 1081HV Amsterdam, the Netherlands. 3. Department of Surgical Oncology, VU University Medical Center, De Boelelaan 1117, 1081HV Amsterdam, the Netherlands.
Abstract
PURPOSE: To evaluate the feasibility of combining transcatheter computed tomography (CT) arterial portography or transcatheter CT hepatic arteriography with percutaneous liver ablation for optimized and repeated tumor exposure. MATERIALS AND METHODS: Study participants were 20 patients (13 men and 7 women; mean age, 59.4 y; range, 40-76 y) with unresectable liver-only malignancies--14 with colorectal liver metastases (29 lesions), 5 with hepatocellular carcinoma (7 lesions), and 1 with intrahepatic cholangiocarcinoma (2 lesions)--that were obscure on nonenhanced CT. A catheter was placed within the superior mesenteric artery (CT arterial portography) or in the hepatic artery (CT hepatic arteriography). CT arterial portography or CT hepatic arteriography was repeatedly performed after injecting 30-60 mL 1:2 diluted contrast material to plan, guide, and evaluate ablation. The operator confidence levels and the liver-to-lesion attenuation differences were assessed as well as needle-to-target mismatch distance, technical success, and technique effectiveness after 3 months. RESULTS: Technical success rate was 100%; there were no major complications. Compared with conventional unenhanced CT, operator confidence increased significantly for CT arterial portography or CT hepatic arteriography cases (P < .001). The liver-to-lesion attenuation differences between unenhanced CT, contrast-enhanced CT, and CT arterial portography or CT hepatic arteriography were statistically significant (mean attenuation difference, 5 HU vs 28 HU vs 70 HU; P < .001). Mean needle-to-target mismatch distance was 2.4 mm ± 1.2 (range, 0-12.0 mm). Primary technique effectiveness at 3 months was 87% (33 of 38 lesions). CONCLUSIONS: In patients with technically unresectable liver-only malignancies, single-session CT arterial portography-guided or CT hepatic arteriography-guided percutaneous tumor ablation enables repeated contrast-enhanced imaging and real-time contrast-enhanced CT fluoroscopy and improves lesion conspicuity.
PURPOSE: To evaluate the feasibility of combining transcatheter computed tomography (CT) arterial portography or transcatheter CT hepatic arteriography with percutaneous liver ablation for optimized and repeated tumor exposure. MATERIALS AND METHODS: Study participants were 20 patients (13 men and 7 women; mean age, 59.4 y; range, 40-76 y) with unresectable liver-only malignancies--14 with colorectal liver metastases (29 lesions), 5 with hepatocellular carcinoma (7 lesions), and 1 with intrahepatic cholangiocarcinoma (2 lesions)--that were obscure on nonenhanced CT. A catheter was placed within the superior mesenteric artery (CT arterial portography) or in the hepatic artery (CT hepatic arteriography). CT arterial portography or CT hepatic arteriography was repeatedly performed after injecting 30-60 mL 1:2 diluted contrast material to plan, guide, and evaluate ablation. The operator confidence levels and the liver-to-lesion attenuation differences were assessed as well as needle-to-target mismatch distance, technical success, and technique effectiveness after 3 months. RESULTS: Technical success rate was 100%; there were no major complications. Compared with conventional unenhanced CT, operator confidence increased significantly for CT arterial portography or CT hepatic arteriography cases (P < .001). The liver-to-lesion attenuation differences between unenhanced CT, contrast-enhanced CT, and CT arterial portography or CT hepatic arteriography were statistically significant (mean attenuation difference, 5 HU vs 28 HU vs 70 HU; P < .001). Mean needle-to-target mismatch distance was 2.4 mm ± 1.2 (range, 0-12.0 mm). Primary technique effectiveness at 3 months was 87% (33 of 38 lesions). CONCLUSIONS: In patients with technically unresectable liver-only malignancies, single-session CT arterial portography-guided or CT hepatic arteriography-guided percutaneous tumor ablation enables repeated contrast-enhanced imaging and real-time contrast-enhanced CT fluoroscopy and improves lesion conspicuity.
Authors: Robert M Pohlman; James L Hinshaw; Timothy J Ziemlewicz; Meghan G Lubner; Shane A Wells; Fred T Lee; Marci L Alexander; Kelly L Wergin; Tomy Varghese Journal: Ultrasound Med Biol Date: 2021-05-16 Impact factor: 3.694
Authors: Marleen C A M Melenhorst; Hester J Scheffer; Laurien G P H Vroomen; Geert Kazemier; M Petrousjka van den Tol; Martijn R Meijerink Journal: Cardiovasc Intervent Radiol Date: 2015-05-21 Impact factor: 2.740
Authors: Hester J Scheffer; Anita G M Stam; Bart Geboers; Laurien G P H Vroomen; Alette Ruarus; Beaunelle de Bruijn; M Petrousjka van den Tol; Geert Kazemier; Martijn R Meijerink; Tanja D de Gruijl Journal: Oncoimmunology Date: 2019-08-28 Impact factor: 8.110
Authors: Robbert S Puijk; Valentijn Ziedses des Plantes; Sanne Nieuwenhuizen; Alette H Ruarus; Laurien G P H Vroomen; Marcus C de Jong; Bart Geboers; Caroline J Hoedemaker-Boon; Deirdre H Thöne-Passchier; Ceylan C Gerçek; Jan J J de Vries; Petrousjka M P van den Tol; Hester J Scheffer; Martijn R Meijerink Journal: Cardiovasc Intervent Radiol Date: 2019-06-26 Impact factor: 2.740
Authors: Hester J Scheffer; Laurien G P H Vroomen; Karin Nielsen; Aukje A J M van Tilborg; Emile F I Comans; Cornelis van Kuijk; Bram B van der Meijs; Janneke van den Bergh; Petrousjka M P van den Tol; Martijn R Meijerink Journal: BMC Cancer Date: 2015-10-24 Impact factor: 4.430
Authors: Aukje A J M van Tilborg; Hester J Scheffer; Marcus C de Jong; Laurien G P H Vroomen; Karin Nielsen; Cornelis van Kuijk; Petrousjka M P van den Tol; Martijn R Meijerink Journal: Cardiovasc Intervent Radiol Date: 2016-07-07 Impact factor: 2.740