title: A novel needle guide system to perform percutaneous laser ablation of liver tumors using the multifiber technique.
abstract: BACKGROUND
  Previous studies have shown that laser ablation with the multifiber technique is effective in the treatment of liver tumors. However, the correct positioning of multiple needles may be challenging.
  
  
  OBJECTIVE
  To investigate the use of a novel needle guide system that was developed to perform percutaneous laser ablation of liver tumors with the multifiber technique under ultrasonographic guidance.
  
  
  METHODS
  Between February 2009 and June 2011, 116 patients (104 hepatocellular carcinomas and 12 metastases) with 127 liver nodules (median diameter, 3.0 cm; range, 1.5-6.0) were treated. Nineteen nodules were in high-risk locations. A needle guide with separate channels to insert two needles in a parallel position and at a prefixed distance was used.
  
  
  RESULTS
  Needles were positioned inside the target nodule easily and quickly, and correct spacing (1.5-1.8 cm) between light sources was immediately achieved. Complete tumor ablation was achieved in a single session in 112 (88.2%) lesions. In nodules ≤3.0 cm and >3.0 cm in size, ablation was complete in 93.6% and 79.6% of cases, respectively. Of note, complete ablation was achieved in 91.7% of nodules up to 5.0 cm.
  
  
  CONCLUSIONS
  With the new guidance system, needles could be inserted in parallel fashion, which facilitated positioning the needles in geometrical configurations to maximize the ablative effect. Worthy of note, the complete ablation rate in nodules >3.0 cm using the new guide system was higher than what has been reported in the literature so far.
authors.affiliation: Liver Unit, Cardarelli Hospital, Naples.
authors.forename: Giovan Giuseppe
authors.initials: GG
authors.lastname: Di Costanzo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: D'Adamo
authors.forename: Raffaella
authors.initials: R
authors.lastname: Tortora
authors.forename: Filomena
authors.initials: F
authors.lastname: Zanfardino
authors.forename: Silvana
authors.initials: S
authors.lastname: Mattera
authors.forename: Giampiero
authors.initials: G
authors.lastname: Francica
authors.forename: Claudio Maurizio
authors.initials: CM
authors.lastname: Pacella
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000295:instrumentation* / Q000379:methods*; D008099:Liver / Q000000981:diagnostic imaging / Q000601:surgery; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009339:Needles; D011446:Prospective Studies; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000295:instrumentation* / Q000379:methods*
keywords: Ablation procedures; laser; liver; ultrasound