title: Transpulmonary computed tomography-guided radiofrequency ablation of liver neoplasms abutting the diaphragm with multiple bipolar electrodes.
abstract: BACKGROUND
  Neoplasm abutting the diaphragm is one kind of the special sites of liver neoplasms treated with radiofrequency ablation (RFA), the purpose of this study is to evaluate the feasibility and safety of computed tomography (CT)-guided RFA of liver neoplasms abutting the diaphragm with multiple bipolar electrodes sequentially passing through the lung parenchyma.
  
  
  METHODS
  37 patients were treated with transpulmonary CT-guided RFA. Technical success rate, perioperative complications, and local tumor progression were investigated.
  
  
  RESULTS
  The number of electrode (s) sequentially passing through the lung parenchyma (NPLP) was 1 electrode in 20 patients, 2 electrodes in 14 cases, and 3 electrodes in 3 cases. Technical success rate was 100%. The most of the perioperative complications were self-limiting and mainly included pneumothorax (11 cases, 2 needed percutaneous drainage), hemorrhage of the electrode track in the lung parenchyma (6 cases), a small amount of hemoperitoneum in perihepatic space (8 cases) and discomfort of the right shoulder (7 cases). Local tumor progression occurred in 6 cases during the follow-up (3-12 months). Multivariate logistic regression analysis showed that the incidence of pneumothorax was not related to NPLP (P = 0.50), length of the electrode (s) in the lung parenchyma (P = 0.18), types of anesthesia (P = 0.10), and indwelling time of the electrode (s) in the lung parenchyma (P = 0.28).
  
  
  CONCLUSIONS
  CT-guided RFA of liver neoplasms abutting the diaphragm with multiple bipolar electrodes sequentially passing through the lung parenchyma is a feasible and safe therapeutic option.
authors.forename: Q
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
authors.forename: X
authors.initials: X
authors.lastname: Li
authors.forename: J
authors.initials: J
authors.lastname: Pan
authors.forename: Z
authors.initials: Z
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation; D003964:Diaphragm / Q000293:injuries / Q000473:pathology*; D004566:Electrodes; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D019990:Perioperative Care; D011379:Prognosis; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000379:methods*; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000379:methods*