Roberto Luigi Cazzato1,2, Jean-Benoit Battistuzzi3, Vittorio Catena4, Rosario Francesco Grasso5, Bruno Beomonte Zobel6, Emiliano Schena7, Xavier Buy8, Jean Palussiere9. 1. Department of Radiology, Institut Bergonié, 229 Cours de l'Argonne, 33000, Bordeaux, France. r.cazzato@unicampus.it. 2. Department of Radiology and Diagnostic Imaging, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128, Rome, Italy. r.cazzato@unicampus.it. 3. Department of Radiology, Institut Bergonié, 229 Cours de l'Argonne, 33000, Bordeaux, France. j.battistuzzi@bordeaux.unicancer.fr. 4. Department of Radiology, Institut Bergonié, 229 Cours de l'Argonne, 33000, Bordeaux, France. vittoriocatena@gmail.com. 5. Department of Radiology and Diagnostic Imaging, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128, Rome, Italy. r.grasso@unicampus.it. 6. Department of Radiology and Diagnostic Imaging, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128, Rome, Italy. b.zobel@unicampus.it. 7. Unit of Measurements and Biomedical Instrumentations, Biomedical Engineering Laboratory, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 198, 00128, Rome, Italy. e.schena@unicampus.it. 8. Department of Radiology, Institut Bergonié, 229 Cours de l'Argonne, 33000, Bordeaux, France. x.buy@bordeaux.unicancer.fr. 9. Department of Radiology, Institut Bergonié, 229 Cours de l'Argonne, 33000, Bordeaux, France. j.palussiere@bordeaux.unicancer.fr.
Abstract
AIM: To compare cone-beam CT (CBCT) versus computed tomography (CT) guidance in terms of time needed to target and place the radiofrequency ablation (RFA) electrode on lung tumours. MATERIALS AND METHODS: Patients at our institution who received CBCT- or CT-guided RFA for primary or metastatic lung tumours were retrospectively included. Time required to target and place the RFA electrode within the lesion was registered and compared across the two groups. Lesions were stratified into three groups according to their size (<10, 10-20, >20 mm). Occurrences of electrode repositioning, repositioning time, RFA complications, and local recurrence after RFA were also reported. RESULTS: Forty tumours (22 under CT, 18 under CBCT guidance) were treated in 27 patients (19 male, 8 female, median age 67.25 ± 9.13 years). Thirty RFA sessions (16 under CBCT and 14 under CT guidance) were performed. Multivariable linear regression analysis showed that CBCT was faster than CT to target and place the electrode within the tumour independently from its size (β = -9.45, t = -3.09, p = 0.004). Electrode repositioning was required in 10/22 (45.4 %) tumours under CT guidance and 5/18 (27.8 %) tumours under CBCT guidance. Pneumothoraces occurred in 6/14 (42.8 %) sessions under CT guidance and in 6/16 (37.5 %) sessions under CBCT guidance. Two recurrences were noted for tumours receiving CBCT-guided RFA (2/17, 11.7 %) and three after CT-guided RFA (3/19, 15.8 %). CONCLUSION: CBCT with live 3D needle guidance is a useful technique for percutaneous lung ablation. Despite lesion size, CBCT allows faster lung RFA than CT.
AIM: To compare cone-beam CT (CBCT) versus computed tomography (CT) guidance in terms of time needed to target and place the radiofrequency ablation (RFA) electrode on lung tumours. MATERIALS AND METHODS:Patients at our institution who received CBCT- or CT-guided RFA for primary or metastatic lung tumours were retrospectively included. Time required to target and place the RFA electrode within the lesion was registered and compared across the two groups. Lesions were stratified into three groups according to their size (<10, 10-20, >20 mm). Occurrences of electrode repositioning, repositioning time, RFA complications, and local recurrence after RFA were also reported. RESULTS: Forty tumours (22 under CT, 18 under CBCT guidance) were treated in 27 patients (19 male, 8 female, median age 67.25 ± 9.13 years). Thirty RFA sessions (16 under CBCT and 14 under CT guidance) were performed. Multivariable linear regression analysis showed that CBCT was faster than CT to target and place the electrode within the tumour independently from its size (β = -9.45, t = -3.09, p = 0.004). Electrode repositioning was required in 10/22 (45.4 %) tumours under CT guidance and 5/18 (27.8 %) tumours under CBCT guidance. Pneumothoraces occurred in 6/14 (42.8 %) sessions under CT guidance and in 6/16 (37.5 %) sessions under CBCT guidance. Two recurrences were noted for tumours receiving CBCT-guided RFA (2/17, 11.7 %) and three after CT-guided RFA (3/19, 15.8 %). CONCLUSION: CBCT with live 3D needle guidance is a useful technique for percutaneous lung ablation. Despite lesion size, CBCT allows faster lung RFA than CT.
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