title: CT fluoroscopy-guided closed-tip catheter placement before regional hyperthermia treatment of soft tissue sarcomas: 5-Year experience in 35 consecutive patients.
abstract: OBJECTIVE
  This study was designed to assess technical success and complications in patients with high-risk soft tissue sarcomas undergoing CT fluoroscopy-guided closed-tip catheter placement before treatment with combined chemotherapy and regional hyperthermia.
  
  
  METHODS
  This retrospective study comprised all patients referred for insertion of closed-tip catheters for the introduction of thermometry probes before regional hyperthermia treatment at a single university centre from 2010 to 2015. Catheter placements were performed under local anaesthesia and intermittent CT fluoroscopy guidance. Technical success, complication rate, duration of catheter insertion and dose-length product (DLP) were analysed. Technical success was defined as intratumoural catheter placement suitable for subsequent thermometry.
  
  
  RESULTS
  A total of 35 procedures were performed on 35 patients (22 men, 13 women). In 34 out of 35 interventions catheters were inserted successfully; in one patient catheter placement was not feasible. No intra-interventional complications occurred. In six patients post-interventional complications were observed - two major (one abscess formation and one severe catheter dislocation) and four minor complications. Technical failure was observed in 11.4% of patients, especially catheter kinking. A total of 55 catheters were placed, with a mean number of 1.7 ± 0.7 per patient. Mean total DLP was 723.2 ± 355.9 mGy*cm.
  
  
  CONCLUSIONS
  CT fluoroscopy-guided closed-tip catheter placement into high-risk soft tissue sarcomas was characterised by high technical success and relatively low complication rate. While major complications were rarely observed, catheter-kinking preventing successful thermometry represented the most frequent technical failure.
authors.affiliation: a Institute for Clinical Radiology, Ludwig Maximilians University Hospital , Munich and.
authors.forename: Frederik F
authors.initials: FF
authors.lastname: Strobl
authors.affiliation: a Institute for Clinical Radiology, Ludwig Maximilians University Hospital , Munich and.
authors.forename: Houman
authors.initials: H
authors.lastname: Azam
authors.affiliation: a Institute for Clinical Radiology, Ludwig Maximilians University Hospital , Munich and.
authors.forename: Jens B
authors.initials: JB
authors.lastname: Schwarz
authors.affiliation: a Institute for Clinical Radiology, Ludwig Maximilians University Hospital , Munich and.
authors.forename: Philipp M
authors.initials: PM
authors.lastname: Paprottka
authors.affiliation: a Institute for Clinical Radiology, Ludwig Maximilians University Hospital , Munich and.
authors.forename: Tobias
authors.initials: T
authors.lastname: Geith
authors.affiliation: b Department of Internal Medicine III , Ludwig Maximilians University Hospital , Munich , Germany.
authors.forename: Sultan
authors.initials: S
authors.lastname: Abdel-Rahman
authors.affiliation: b Department of Internal Medicine III , Ludwig Maximilians University Hospital , Munich , Germany.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Zilles
authors.affiliation: b Department of Internal Medicine III , Ludwig Maximilians University Hospital , Munich , Germany.
authors.forename: Lars H
authors.initials: LH
authors.lastname: Lindner
authors.affiliation: a Institute for Clinical Radiology, Ludwig Maximilians University Hospital , Munich and.
authors.forename: Maximilian F
authors.initials: MF
authors.lastname: Reiser
authors.affiliation: a Institute for Clinical Radiology, Ludwig Maximilians University Hospital , Munich and.
authors.forename: Christoph G
authors.initials: CG
authors.lastname: Trumm
mesh_terms: D000328:Adult; D000368:Aged; D002404:Catheterization / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D006979:Hyperthermia, Induced; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D012509:Sarcoma / Q000000981:diagnostic imaging / Q000628:therapy; D012983:Soft Tissue Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy; D062125:Thermometry; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: CT fluoroscopy; Closed-tip catheter placement; regional hyperthermia; soft tissue sarcoma; thermometry