Artificial ascites and pneumoperitoneum to facilitate thermal ablation of liver tumors: a pictorial essay.
Image-guided percutaneous thermal ablation is increasingly utilized in the treatment of hepatic malignancies. Peripherally located hepatic tumors can be difficult to access or located adjacent to critical structures that can be injured. As a result, ablation of peripheral tumors may be avoided or may be performed too cautiously, leading to inadequate ablation coverage. In these cases, separating the tumor from adjacent critical structures can increase the efficacy and safety of procedures. Artificial ascites and artificial pneumoperitoneum are techniques that utilize fluid and gas, respectively, to insulate critical structures from the thermal ablation zone. Induction of artificial ascites and artificial pneumoperitoneum can enable complete ablation of otherwise inaccessible hepatic tumors, improve tumor visualization, minimize unintended thermal injury to surrounding organs, and reduce post-procedural pain. This pictorial essay illustrates and discusses the proper technique and clinical considerations for successful artificial ascites and pneumoperitoneum creation to facilitate safe peripheral hepatic tumor ablation.
Department of Radiology, Abdominal Imaging and Intervention, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.
Sharath K
SK
Bhagavatula
Department of Radiology, Abdominal Imaging and Intervention, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.|Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan Health System, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA.
Jeffrey F B
JF
Chick
Department of Radiology, Abdominal Imaging and Intervention, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.|Department of Radiology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Nikunj R
NR
Chauhan
Department of Radiology, Abdominal Imaging and Intervention, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA. pshyn@bwh.harvard.edu.
Paul B
PB
Shyn
D001201:Ascites; D017115:Catheter Ablation / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D011028:Pneumoperitoneum, Artificial; D015641:Radiography, Interventional
Artificial ascites; Artificial pneumoperitoneum; Tumor ablation