Usefulness of guiding needles for radiofrequency ablative treatment of liver tumors
Usefulness of guiding needles for radiofrequency ablative treatment of liver tumors
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DOI：
10.1007/s00270-005-0187-9
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发表时间：
2006-08-01
影响因子：
2.9
通讯作者：
Elias, Dominique
中科院分区：
文献类型：
--
作者：
de Baere, Thierry;Abdel Rehim, Mohamed;Elias, Dominique
目的：评估引导针在肝脏肿瘤射频 (RF) 消融治疗中的有效性。方法：42 名患者，年龄 38-78 岁 (57 +/- 17)，患有 42 个肝脏肿瘤（18 个 HCC，24 个结肠癌转移瘤），使用带有外部绝缘护套的 14 号引导针进行射频消融，其中任何 18 号或更小的针都可以插入。 放置，包括专门设计的 3.5 cm LeVeen RF 电极。使用一根引导针对 20 个肿瘤进行单次穿刺活检和射频治疗。在开始射频治疗之前，在最大直径为 35 至 64 毫米的 22 个肿瘤中装入三到五个引导针，需要多次重叠的射频应用。结果：在 20 例射频治疗与活检相结合的情况下，活检始终有贡献。由于鞘管的预先定位，活检后的修改（出血或空气伪影）不会妨碍后续的射频治疗。 22 个大肿瘤通过三到五个预装引导针接受了 5 到 12 次射频应用（平均值 = 6.8）。射频消融区域的最大尺寸为 46 至 94 毫米（平均值 = 55），所有情况下都有消融边缘。 8 至 32 个月（平均值 = 20）后，计算机断层扫描随访显示 22 个肿瘤中的 14 个被认为完全被破坏，并发现了一个肿瘤种植。结论：在治疗需要多次射频应用的大型肿瘤时，Levenen CoAccess 针可以实现精确的肿瘤靶向。它允许通过单个管道进行活检与射频消融相结合。
Purpose: To evaluate the usefulness of a guiding needle for radiofrequency (RF) ablative treatment of liver tumors.Methods: Forty-two patients, 38-78 years old (57 +/- 17), with 42 liver tumors (18 HCC, 24 colon cancer metastases) underwent RF ablation using a 14-gauge guiding needle with an external insulated sheath in which any 18-gauge or smaller needle can be placed, including a specially designed 3.5 cm LeVeen RF electrode. One guiding needle was used in 20 tumors to provide biopsy and RF treatment in a single puncture. Three to five guiding needles were loaded in 22 tumors measuring 35 to 64 mm in their largest diameter before starting RF treatment requiring multiple overlapping RF applications.Results: In the 20 RF treatments combined with biopsy, the biopsy was always contributive. Because of pre-positioning of the sheath, postbiopsy modifications (bleeding or air artifacts) did not hinder subsequent RF treatment. The 22 large tumors received 5 to 12 RF applications (mean = 6.8) through the three to five preloaded guiding needles. The RF ablation zones measured 46 to 94 mm (mean = 55) in their largest dimension, with ablative margins in all cases. After 8 to 32 months (mean = 20), 14 of the 22 tumors are considered completely destroyed on computed tomography follow-up and one tumor seeding has been found.Conclusion: The Leveen CoAccess needle allows precise tumor targeting when treating large tumors requiring multiple RF applications. It allows biopsies combined with RF ablation through a single tract.