CT-guided navigation of percutaneous hepatic and renal radiofrequency ablation under high-frequency jet ventilation: feasibility study.

摘要

PURPOSE: Computed tomography (CT)-guided navigation during percutaneous radiofrequency (RF) ablations of liver and kidney lesions is hampered by respiratory motion and time-dependent lesion conspicuity after contrast agent injection. Therefore, target immobilization by general anesthesia with high-frequency jet ventilation (HFJV) instead of conventional ventilation (CV) with repeated breath-holds may facilitate and speed up navigation of RF ablation probes. MATERIALS AND METHODS: Nineteen consecutive patients who underwent percutaneous RF ablation of liver (n = 9) or renal tumors (n = 10) with CT guidance under HFJV (n = 9) or CV (n = 10) were included. The choice of the anesthesiologic technique was left to the discretion of the interventionalist. Complexity of the intervention (ie, number of lesions ablated per session, conspicuity of the lesion on nonenhanced CT, and access pathway), volume of the ablated tissue, radiation exposure, and complications were compared between the HFJV and CV groups. RESULTS: In this feasibility study, a statistically significant radiation dose reduction (P < .05) was noted in the HFJV group compared with the CV group for liver and renal RF ablation. No complications were observed in the HFJV group, whereas renal subcapsular hematoma (n = 2) and pulmonary embolism (n = 1) occurred in the CV group. CONCLUSIONS: Percutaneous CT-guided navigation of RF ablation probes under HFJV is feasible and safe. It might be advantageous for the treatment of complex kidney and liver tumors, allowing less irradiation exposure to the patient and the interventional radiologist.