Flat-panel cone-beam CT-guided radiofrequency ablation of very small (≤ 1.5 cm) liver tumors: technical note on a preliminary experience.
OBJECTIVE
The aim of the present study was to investigate the technical feasibility of flat-panel cone-beam CT (CBCT)-guided radiofrequency ablation (RFA) of very small (<1.5 cm) liver tumors.


METHODS
Patients included were candidates for hepatic percutaneous RFA as they had single biopsy-proven hepatic tumors sized ≤ 1.5 cm and poorly defined on ultrasonography. Following apnea induction, unenhanced CBCT scans were acquired and used to deploy the RF electrode with the aid of a virtual navigation system. If the tumor was not clearly identified on the unenhanced CBCT scan, a right retrograde arterial femoral access was established to carry out hepatic angiography and localize the tumor. Patients' lesions and procedural variables were recorded and analyzed.


RESULTS
Three patients (2 male and 1 female), aged 68, 76, and 87 years were included; 3 lesions (2 hepato-cellular carcinoma and 1 metastasis from colorectal cancer) were treated. One patient required hepatic angiography. Cycles of apnea used to acquire CBCT images and to deploy the electrode lasted <120 s. Mean fluoroscopic time needed to deploy the electrode was 36.6 ± 5.7 min. Mean overall procedural time was 66.0 ± 22.9 min. No peri- or post-procedural complications were noted. No cases of incomplete ablation were noted at 1-month follow-up.


CONCLUSIONS
Percutaneous CBCT-guided liver RFA with or without arterial hepatic angiography is technically feasible.
Department of Radiology, Institut Bergonié 229 Cours de l'Argonne, 33000, Bordeaux, France, r.cazzato@unicampus.it.
Roberto Luigi
RL
Cazzato
Xavier
X
Buy
Nicolas
N
Alberti
Mariane
M
Fonck
Rosario Francesco
RF
Grasso
Jean
J
Palussière
D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000379:methods*; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D015641:Radiography, Interventional / Q000379:methods*; D016896:Treatment Outcome