Percutaneous radiofrequency ablation for lung tumors beneath the rib under CT fluoroscopic guidance with gantry tilt.
BACKGROUND
Radiofrequency (RF) ablation of lung tumors has become a treatment of choice, especially for unresectable cases. However, RF ablation of small lung lesions located just beneath the rib is difficult.


OBJECTIVE
To evaluate the efficacy and safety of gantry tilting for the performance of RF ablation of peripheral lesions located beneath the rib.


METHODS
Our study was based on 18 of 293 lesions in the lung for which RF ablation was performed under CT scan fluoroscopic guidance at our institution between October 2004 and March 2009. For these 18 lesions, RF ablation was performed with gantry tilting because a rib blocked visualization of the RF ablation route even after other attempts had been made to change the relationship between the target and the rib.


RESULTS
All RF needles, with only one exception, were successfully advanced to hit the tumor. The commonest complication was a pneumothorax, which occurred in seven procedures. No serious complications occurred. The progression-free rates were 82.4% at 6 months, 62.5% at 12 months, and 30% at 24 months. Mean local progression-free duration was 17.6+/-11.6 months (range 4-36 months).


CONCLUSIONS
RF ablation under CT scan fluoroscopic guidance with gantry tilt is a useful and safe technique for RF ablation of lung nodules located beneath the rib.
Suzuki
Takanobu
T
Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo, Kyoto, Japan. yamagami@koto.kpu-m.ac.jp
Yamagami
Takuji
T
Tanaka
Osamu
O
Yoshimatsu
Rika
R
Miura
Hiroshi
H
Nishimura
Tsunehiko
T
D000328:Adult; D000368:Aged; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D015641:Radiography, Interventional; D012272:Ribs; D013997:Time Factors; D036542:Tomography, Spiral Computed / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome