title: Percutaneous radiofrequency ablation for lung tumors beneath the rib under CT fluoroscopic guidance with gantry tilt.
abstract: 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.
authors.affiliation: Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo, Kyoto, Japan. yamagami@koto.kpu-m.ac.jp
authors.forename: Takanobu
authors.initials: T
authors.lastname: Suzuki
authors.forename: Takuji
authors.initials: T
authors.lastname: Yamagami
authors.forename: Osamu
authors.initials: O
authors.lastname: Tanaka
authors.forename: Rika
authors.initials: R
authors.lastname: Yoshimatsu
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Miura
authors.forename: Tsunehiko
authors.initials: T
authors.lastname: Nishimura
mesh_terms: 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