학술논문
Thermal ablation of ultrasound and non-contrast computed tomography invisible primary and secondary liver tumors: targeting by selective intra-arterial lipiodol injection
ORIGINAL ARTICLE
ORIGINAL ARTICLE
Document Type
Report
Author
Source
Diagnostic and Interventional Radiology. July 2023, Vol. 29 Issue 4, p609, 5 p.
Subject
Language
English
ISSN
1305-3825
Abstract
Percutaneous thermal ablation of primary and secondary liver tumors is an accepted alternative to surgery for tumors measuring less than 3 cm. (1-3) Thermal ablation is typically guided by ultrasound [...]
PURPOSE To evaluate the technical feasibility and outcomes of thermal ablation following selective intra-arterial lipiodol injection (SIALI) for targeting primary and secondary liver tumors invisible on ultrasound (US) and non-contrast computed tomography (CT). METHODS This retrospective study included 18 patients with 20 tumors (67% male, mean age 60.8 [+ or -] 12.1 years). The 20 tumors included 15 liver metastases and 5 hepatocellular carcinomas. All patients underwent single-session SIALI and subsequent CT-guided thermal ablation. The primary outcome was a technical success, defined as visualization of the tumor after SIALI and successful thermal ablation. Secondary outcomes were local recurrence rate and procedure-related complications. RESULTS The median tumor size was 1.5 (1-2.5) cm. In addition, SIALI was performed with a median volume of 3 (1-10) mL of lipiodol resulting in intra-tumoral iodized oil accumulation in 19 tumors and negative imprint with iodized oil accumulation of the surrounding liver parenchyma in 1 tumor. The technical success rate was 100%. No local occurrence was observed at a mean follow-up time of 3 [+ or -] 2.5 years. CONCLUSION SIALI to tag liver tumors not visible with US and non-contrast CT before percutaneous ablation is highly feasible and has a high success rate for the treatment of both primary and secondary liver tumors. KEYWORDS HCC, invisible tumor, liver metastases, selective intra-arterial lipiodol injection, thermal ablation
PURPOSE To evaluate the technical feasibility and outcomes of thermal ablation following selective intra-arterial lipiodol injection (SIALI) for targeting primary and secondary liver tumors invisible on ultrasound (US) and non-contrast computed tomography (CT). METHODS This retrospective study included 18 patients with 20 tumors (67% male, mean age 60.8 [+ or -] 12.1 years). The 20 tumors included 15 liver metastases and 5 hepatocellular carcinomas. All patients underwent single-session SIALI and subsequent CT-guided thermal ablation. The primary outcome was a technical success, defined as visualization of the tumor after SIALI and successful thermal ablation. Secondary outcomes were local recurrence rate and procedure-related complications. RESULTS The median tumor size was 1.5 (1-2.5) cm. In addition, SIALI was performed with a median volume of 3 (1-10) mL of lipiodol resulting in intra-tumoral iodized oil accumulation in 19 tumors and negative imprint with iodized oil accumulation of the surrounding liver parenchyma in 1 tumor. The technical success rate was 100%. No local occurrence was observed at a mean follow-up time of 3 [+ or -] 2.5 years. CONCLUSION SIALI to tag liver tumors not visible with US and non-contrast CT before percutaneous ablation is highly feasible and has a high success rate for the treatment of both primary and secondary liver tumors. KEYWORDS HCC, invisible tumor, liver metastases, selective intra-arterial lipiodol injection, thermal ablation