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Feasibility, safety, and efficacy of artificial carbon dioxide pneumothorax for computed tomography fluoroscopy-guided percutaneous radiofrequency ablation of hepatocellular carcinoma

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Japanese Journal of Radiology Aims and scope Submit manuscript

Abstract

Purpose

To retrospectively assess the feasibility, safety, and efficacy of artificial carbon dioxide (CO2) pneumothorax for computed tomography (CT) fluoroscopy-guided percutaneous radiofrequency (RF) ablation of hepatocellular carcinoma (HCC).

Materials and methods

This study included 26 sessions of 24 patients in whom the creation of artificial CO2 pneumothorax was attempted to avoid the transpulmonary route during CT fluoroscopy-guided percutaneous RF ablation of HCC between April 2011 and December 2017. In these 26 sessions, 29 HCCs (mean tumor diameter: 12 mm, range: 6–22 mm) were treated.

Results

Adequate lung displacement after induction of artificial CO2 pneumothorax was achieved in 23 of the 26 sessions (88.5%). In the remaining three sessions, transpulmonary RF ablation, transthoracic extrapulmonary RF ablation after switching to an artificial pleural effusion procedure, or RF ablation with electrode insertion in the caudal-cranial oblique direction was performed. No major complications were found. Among the 29 treated tumors, one (3.4%) showed local progression, and the other 28 (96.6%) were completely ablated at the last follow-up (mean follow-up period: 39.3 months, range: 7–78 months).

Conclusion

Artificial CO2 pneumothorax for CT fluoroscopy-guided percutaneous RF ablation appeared to be a feasible, safe, and useful therapeutic option for HCC.

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Authors and Affiliations

  1. Department of Diagnostic and Therapeutic Radiology, Kawasaki Medical School, 2-6-1, Nakasange, Kita-ku, Okayama, 700-8505, Japan

    Kentaro Shibamoto, Yuko Fukuhara & Katsuya Kato

  2. Department of Radiology, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan

    Hidefumi Mimura

  3. Department of General Internal Medicine 2, Kawasaki Medical School, 2-6-1, Nakasange, Kita-ku, Okayama, 700-8505, Japan

    Ken Nishino & Hirofumi Kawamoto

Authors
  1. Kentaro Shibamoto
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  2. Hidefumi Mimura
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  3. Yuko Fukuhara
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  4. Ken Nishino
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  5. Hirofumi Kawamoto
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  6. Katsuya Kato
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Corresponding author

Correspondence to Kentaro Shibamoto.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Our institution’s Ethics Committee approved this retrospective study. The requirement for written informed consent for this study was waived because of its retrospective nature.

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Shibamoto, K., Mimura, H., Fukuhara, Y. et al. Feasibility, safety, and efficacy of artificial carbon dioxide pneumothorax for computed tomography fluoroscopy-guided percutaneous radiofrequency ablation of hepatocellular carcinoma. Jpn J Radiol 39, 1119–1126 (2021). https://doi.org/10.1007/s11604-021-01148-y

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  • DOI: https://doi.org/10.1007/s11604-021-01148-y

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