title: CT-Guided Percutaneous Microwave Ablation of Tumors in the Hepatic Dome: Assessment of Efficacy and Safety.
abstract: OBJECTIVE
  To evaluate the technique, efficacy, safety, and clinical outcomes of CT-guided microwave ablation of tumors in the hepatic dome.
  
  
  METHODS
  Retrospective review was conducted of 46 consecutive patients (31 men and 15 women; mean age, 64 y) treated with CT-guided microwave ablation for hepatic-dome tumors between June 2011 and December 2014. Baseline demographics of sex, tumor diagnosis, tumor location, tumor size, and technical details were recorded. Technical success was evaluated. Treatment response was assessed per European Association for the Study of the Liver criteria. Overall success and overall survival were calculated, and complications were recorded.
  
  
  RESULTS
  Forty-eight tumors were treated. Tumor locations included segments VIII (n = 32), VII (n = 10), and VIa (n = 6). Mean tumor size was 2.4 cm (range, 0.9-5.2 cm). Thirty-four tumors (70%) were treated following creation of artificial ascites with 0.9% normal saline solution (mean volume, 1,237 mL; range, 300-3,000 mL). The technical success rate was 100%, and the complete response rate was 94%. Overall survival rate was 73.9% over 24.7 months of follow-up. There were no major complications. Two patients experienced small, asymptomatic pneumothoraces that were aspirated at the time of the procedure and required no further treatment.
  
  
  CONCLUSIONS
  CT-guided microwave ablation of tumors in the hepatic dome is associated with a high technical success rate, high complete response rate, and low complication rate.
authors.affiliation: Department of Radiology, Division of Interventional Radiology, Massachusetts General Hospital, White 270, Boston, MA 02114. Electronic address: nasvadi@mgh.harvard.edu.
authors.forename: Nazanin H
authors.initials: NH
authors.lastname: Asvadi
authors.affiliation: Department of Radiology, Division of Interventional Radiology, Massachusetts General Hospital, White 270, Boston, MA 02114.
authors.forename: Arash
authors.initials: A
authors.lastname: Anvari
authors.affiliation: Department of Radiology, Division of Interventional Radiology, Massachusetts General Hospital, White 270, Boston, MA 02114.
authors.forename: Raul N
authors.initials: RN
authors.lastname: Uppot
authors.affiliation: Department of Radiology, Division of Interventional Radiology, Massachusetts General Hospital, White 270, Boston, MA 02114.
authors.forename: Ashraf
authors.initials: A
authors.lastname: Thabet
authors.affiliation: Department of Medicine, Division of Hematology/Oncology, Massachusetts General Hospital, White 270, Boston, MA 02114.
authors.forename: Andrew X
authors.initials: AX
authors.lastname: Zhu
authors.affiliation: Department of Radiology, Division of Interventional Radiology, Massachusetts General Hospital, White 270, Boston, MA 02114.
authors.forename: Ronald S
authors.initials: RS
authors.lastname: Arellano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008872:Microwaves / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome