title: Usefulness of guiding needles for radiofrequency ablative treatment of liver tumors.
abstract: OBJECTIVE
  To evaluate the usefulness of a guiding needle for radiofrequency (RF) ablative treatment of liver tumors.
  
  
  METHODS
  Forty-two patients, 38-78 years old (57 +/- 17), with 42 liver tumors (18 HCC, 24 colon cancer metastases) underwent RF ablation using a 14-gauge guiding needle with an external insulated sheath in which any 18-gauge or smaller needle can be placed, including a specially designed 3.5 cm LeVeen RF electrode. One guiding needle was used in 20 tumors to provide biopsy and RF treatment in a single puncture. Three to five guiding needles were loaded in 22 tumors measuring 35 to 64 mm in their largest diameter before starting RF treatment requiring multiple overlapping RF applications.
  
  
  RESULTS
  In the 20 RF treatments combined with biopsy, the biopsy was always contributive. Because of pre-positioning of the sheath, postbiopsy modifications (bleeding or air artifacts) did not hinder subsequent RF treatment. The 22 large tumors received 5 to 12 RF applications (mean = 6.8) through the three to five preloaded guiding needles. The RF ablation zones measured 46 to 94 mm (mean = 55) in their largest dimension, with ablative margins in all cases. After 8 to 32 months (mean = 20), 14 of the 22 tumors are considered completely destroyed on computed tomography follow-up and one tumor seeding has been found.
  
  
  CONCLUSIONS
  The Leveen CoAccess needle allows precise tumor targeting when treating large tumors requiring multiple RF applications. It allows biopsies combined with RF ablation through a single tract.
authors.affiliation: Département d'Imagerie Médicale, Institut Gustave Roussy, Villejuif 94805, France. debaere@igr.fr
authors.forename: Thierry
authors.initials: T
authors.lastname: de Baère
authors.forename: Mohamed Abdel
authors.initials: MA
authors.lastname: Rehim
authors.forename: Christophe
authors.initials: C
authors.lastname: Teriitheau
authors.forename: Frederic
authors.initials: F
authors.lastname: Deschamps
authors.forename: Mathieu
authors.initials: M
authors.lastname: Lapeyre
authors.forename: Clarisse
authors.initials: C
authors.lastname: Dromain
authors.forename: Valérie
authors.initials: V
authors.lastname: Boige
authors.forename: Michel
authors.initials: M
authors.lastname: Ducreux
authors.forename: Dominique
authors.initials: D
authors.lastname: Elias
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000628:therapy; D017115:Catheter Ablation / Q000295:instrumentation* / Q000379:methods; D003110:Colonic Neoplasms / Q000473:pathology; D004867:Equipment Design; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000628:therapy*; D008875:Middle Aged; D009339:Needles; D011846:Radio Waves