Lorenzo Monfardini1, Franco Orsi2, Rosalba Caserta3, Claudio Sallemi1, Paolo Della Vigna2, Guido Bonomo2, Gianluca Varano2, Luigi Solbiati4,5, Giovanni Mauri2. 1. a Department of Radiology , Fondazione Poliambulanza Istituto Ospedaliero , Brescia , Italy. 2. b Interventional Radiology , IEO Istituto Europeo di Oncologia IRCCS , Milano , Italy. 3. c Intensive Care Unit , Fondazione Poliambulanza Istituto Ospedaliero , Brescia , Italy. 4. d Department of Radiology , Istituto Clinico Humanitas , Rozzano , Italy. 5. e Department of Biomedical Sciences , Humanitas University , Milan , Italy.
Abstract
PURPOSE: To assess the feasibility of fusion imaging between intraprocedural ultrasound (US) and contrast-enhanced cone-beam CT (CBCT) for small (< 2 cm) hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Six patients (five males, one female, age range 58-80, mean 69 years), with small (mean diameter 16.8 mm) HCC poorly visible at US underwent percutaneous microwave ablation under US/CBCT fusion guidance. During general anesthesia with apnea control, a contrast- enhanced CBCT was acquired with an active tracker. Subsequently, real time US images were fused with CBCT images, and treatment performed under fusion imaging guidance. Feasibility of fusion imaging and percutaneous ablation were assessed, correct targeting (distance from center of tumor and center of ablation area <5 mm) and one-month primary technical efficacy were evaluated. Major and minor complications as well as overall procedural time were recorded. RESULTS: US/CBCT fusion was feasible in all cases, allowing for completion of the treatment as previously planned (technical success 100%). Correct targeting was achieved in 4/6 cases (66%), while in two cases, center of tumor and center of ablated area were respectively 7 and 8 mm distant. At 1 month CT scan, all tumors were completely ablated (primary technical efficacy 100%). No major or minor complications occurred. Mean overall procedure time was 127 min. CONCLUSIONS: US/CBCT fusion is a feasible technique for liver ablation, and might represent a useful tool to increase the correct targeting of poorly US-visible HCC nodules in the angio suite.
PURPOSE: To assess the feasibility of fusion imaging between intraprocedural ultrasound (US) and contrast-enhanced cone-beam CT (CBCT) for small (< 2 cm) hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Six patients (five males, one female, age range 58-80, mean 69 years), with small (mean diameter 16.8 mm) HCC poorly visible at US underwent percutaneous microwave ablation under US/CBCT fusion guidance. During general anesthesia with apnea control, a contrast- enhanced CBCT was acquired with an active tracker. Subsequently, real time US images were fused with CBCT images, and treatment performed under fusion imaging guidance. Feasibility of fusion imaging and percutaneous ablation were assessed, correct targeting (distance from center of tumor and center of ablation area <5 mm) and one-month primary technical efficacy were evaluated. Major and minor complications as well as overall procedural time were recorded. RESULTS: US/CBCT fusion was feasible in all cases, allowing for completion of the treatment as previously planned (technical success 100%). Correct targeting was achieved in 4/6 cases (66%), while in two cases, center of tumor and center of ablated area were respectively 7 and 8 mm distant. At 1 month CT scan, all tumors were completely ablated (primary technical efficacy 100%). No major or minor complications occurred. Mean overall procedure time was 127 min. CONCLUSIONS: US/CBCT fusion is a feasible technique for liver ablation, and might represent a useful tool to increase the correct targeting of poorly US-visible HCC nodules in the angio suite.
Authors: Simone Schiaffino; Francesca Serpi; Duccio Rossi; Valerio Ferrara; Ciriaco Buonomenna; Marco Alì; Lorenzo Monfardini; Luca Maria Sconfienza; Giovanni Mauri Journal: J Clin Med Date: 2020-05-16 Impact factor: 4.241
Authors: T R F van Steenbergen; M Smits; T W J Scheenen; I M van Oort; J Nagarajah; M M Rovers; N Mehra; J J Fütterer Journal: Cardiovasc Intervent Radiol Date: 2019-08-23 Impact factor: 2.740
Authors: Serena Carriero; Gianmarco Della Pepa; Lorenzo Monfardini; Renato Vitale; Duccio Rossi; Andrea Masperi; Giovanni Mauri Journal: Diagnostics (Basel) Date: 2021-03-19