Kentaro Shibamoto1, Hidefumi Mimura2, Yuko Fukuhara3, Ken Nishino4, Hirofumi Kawamoto4, Katsuya Kato3. 1. Department of Diagnostic and Therapeutic Radiology, Kawasaki Medical School, 2-6-1, Nakasange, Kita-ku, Okayama, 700-8505, Japan. spab4xq9@yahoo.co.jp. 2. Department of Radiology, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan. 3. Department of Diagnostic and Therapeutic Radiology, Kawasaki Medical School, 2-6-1, Nakasange, Kita-ku, Okayama, 700-8505, Japan. 4. Department of General Internal Medicine 2, Kawasaki Medical School, 2-6-1, Nakasange, Kita-ku, Okayama, 700-8505, Japan.
Abstract
PURPOSE: To retrospectively assess the feasibility, safety, and efficacy of artificial carbon dioxide (CO2) pneumothorax for computed tomography (CT) fluoroscopy-guided percutaneous radiofrequency (RF) ablation of hepatocellular carcinoma (HCC). MATERIALS AND METHODS: This study included 26 sessions of 24 patients in whom the creation of artificial CO2 pneumothorax was attempted to avoid the transpulmonary route during CT fluoroscopy-guided percutaneous RF ablation of HCC between April 2011 and December 2017. In these 26 sessions, 29 HCCs (mean tumor diameter: 12 mm, range: 6-22 mm) were treated. RESULTS: Adequate lung displacement after induction of artificial CO2 pneumothorax was achieved in 23 of the 26 sessions (88.5%). In the remaining three sessions, transpulmonary RF ablation, transthoracic extrapulmonary RF ablation after switching to an artificial pleural effusion procedure, or RF ablation with electrode insertion in the caudal-cranial oblique direction was performed. No major complications were found. Among the 29 treated tumors, one (3.4%) showed local progression, and the other 28 (96.6%) were completely ablated at the last follow-up (mean follow-up period: 39.3 months, range: 7-78 months). CONCLUSION: Artificial CO2 pneumothorax for CT fluoroscopy-guided percutaneous RF ablation appeared to be a feasible, safe, and useful therapeutic option for HCC.
PURPOSE: To retrospectively assess the feasibility, safety, and efficacy of artificial carbon dioxide (CO2) pneumothorax for computed tomography (CT) fluoroscopy-guided percutaneous radiofrequency (RF) ablation of hepatocellular carcinoma (HCC). MATERIALS AND METHODS: This study included 26 sessions of 24 patients in whom the creation of artificial CO2pneumothorax was attempted to avoid the transpulmonary route during CT fluoroscopy-guided percutaneous RF ablation of HCC between April 2011 and December 2017. In these 26 sessions, 29 HCCs (mean tumor diameter: 12 mm, range: 6-22 mm) were treated. RESULTS: Adequate lung displacement after induction of artificial CO2pneumothorax was achieved in 23 of the 26 sessions (88.5%). In the remaining three sessions, transpulmonary RF ablation, transthoracic extrapulmonary RF ablation after switching to an artificial pleural effusion procedure, or RF ablation with electrode insertion in the caudal-cranial oblique direction was performed. No major complications were found. Among the 29 treated tumors, one (3.4%) showed local progression, and the other 28 (96.6%) were completely ablated at the last follow-up (mean follow-up period: 39.3 months, range: 7-78 months). CONCLUSION: Artificial CO2pneumothorax for CT fluoroscopy-guided percutaneous RF ablation appeared to be a feasible, safe, and useful therapeutic option for HCC.