Flat-Panel Cone-Beam Ct-Guided Radiofrequency Ablation of Very Small (≤1.5 cm) Liver Tumors: Technical Note on a Preliminary Experience

Abstract

Percutaneous CBCT-guided liver RFA with or without arterial hepatic angiography is technically feasible.

Ultrasound and cone beam CT fusion for liver ablation: technical note

“…Furthermore, if bleeding should occur, treatment with embolization can be directly performed in the same room, with the patient still under general anesthesia. In fact, we completely agree with Cazzato's attitude [3] in performing general anesthesia not only for the abovementioned technical considerations but moreover for the possibility of completely concentrating on the ongoing procedure. In our series, no major of minor complications occurred, even though the lesions were poorly visible at real time US and treatments were mainly performed relying on the image fusion guidance.…”

“…CBCT has recently been described as a useful tool for identifying liver lesions during percutaneous thermal ablations, and it has been applied for targeting and ablating hepatic lesions in small cohorts of patients. In addition, CBCT has been proposed as a possible alternative or complementary technique for assessing ablation results [10,3]. However, several technical aspects limit the application of CBCT as the sole method for liver tumor ablation guidance.…”

“…However, the technical feasibility of USguided ablations is often limited by poor lesion visualization, due to lack of echogenicity difference or difficult localization in the liver [2]. In these cases, other imaging modalities such as computed tomography (CT), magnetic resonance (MR), or cone beam CT (CBCT) can be used to perform liver ablations [3]. Some techniques to improve conspicuity of target liver lesion for percutaneous ultrasound-guided ablations have been described, including contrast-enhanced US, and fusion imaging of US with previously acquired CT/MR [4].…”

Treatment planning in microwave thermal ablation: clinical gaps and recent research advances

“…However, MR-based thermometry allows monitoring tissue temperature without radiation exposure, whereas the CT-based one requires repeated CT scans with an equivalent dose depending on the treated organ and duration of the procedure. Cazzato et al [116] recently investigated the technical feasibility of flat-panel CBCT-guided RF ablation of very small (<1.5 cm) liver tumours on 3 patients, evidencing no peri-or post-procedural complications or cases of incomplete ablation after 1-month follow-up. Pandeya et al [117] carried out a feasibility study on a CT scan for non-invasive temperature assessment during RF ex vivo liver ablation in a temperature range from 20 to 98 C, finding a CT thermal sensitivity of À0.60 Hounsfield Units (HU)/ C. The negative correlation for the relationship between temperature and HU value was confirmed in [118], where CT thermometry (sequential multi-slice CT scans) was performed during both ex vivo and in vivo experiments on porcine liver specimens undergoing RF ablation.…”

Percutaneous transthoracic localization of pulmonary nodules under C-arm cone-beam CT virtual navigation guidance

“…Recently, CBCT and CBCT virtual navigation systems have been increasingly used in various fields of radiologic interventional procedures (24)(25)(26). CBCT-guided, or CBCT virtual navigation-guided PTNB have been reported to provide very excellent and, at least, equivalent diagnostic accuracy to state-of-the-art CTF-guided PTNB (11,12,27).…”