Abstract
Background
Some small hepatocellular carcinoma (HCC) lesions show as tumor stains by dynamic CT, but cannot be detected by ultrasonography. Percutaneous ethanol injection (PEI) is effective for treating small HCC lesions, but lack of adequate visualization of some lesions can limit its use. In this study, interventional radiographic, CT-fluoroscopically-guided PEI was performed as a new method for treating small HCC lesions that were diffucult to detect by ultrasonography.
Methods
Interventional radiographic, CT-fluoroscopically-guided PEI was performed on 11 patients (12 lesions) with HCC lesions measuring 2 cm or less in diameter. A thin needle was introduced into each tumor under CT-fluoroscopic guidance, with injection of contrast medium into the dominant hepatic artery. While lesions were observed using CT-fluoroscopy with the arteriogram, absolute ethanol was injected into the tumors. The ethanol injection rate and volume were monitored by observation of loss of tumor staining during real-time CT angiography.
Results
Needle introduction was successful in all 12 lesions, and disappearance of tumor staining was immediately observed on CT images after ethanol injection. Complications noted after treatment were local abdominal pain in all 11 patients, a slight fever in 9 patients, pneumothorax, right pleural effusion, and ascites, each in 1 patient. No other serious complications were observed.
Conclusions
Interventional radiographic, CT-fluoroscopically-guided PEI is effective in the treatment of small HCC lesions, which are difficult to show by ultrasonography and treat by conventional PEI.
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References
Shiina S, Yasuda H, Muto H, Tagawa K, Unuma T, Ibukuro K, Inoue Y, Takanashi R. Percutaneous ethanol injection in the treatment of liver neoplasms. AJR 1987;149:949–952.
Livraghi T, Festi D, Monti F, Vettori C. US-guided percutaneous alcohol injection of small hepatic and abdominal tumors. Radiology 1986;161:309–312.
Sheu JC, Huang GT, Chen DS, Sung JL, Yang PM, Wei TC, Lai MY, Su CT, Tsang YM, Hsu HC, Su IJ, Wu TT, Lin JT, Chuang CN. Small hepatocellular carcinoma: intratumor ethanol treatment using new needle and guidance system. Radiology 1987;163:43–48.
Ebara M, Ohto M, Sugiura N, Kita K, Yoshikawa M, Okuda K, Kondo F, Kondo Y. Percutaneous ethanol injection for the treatment of small hepatocellular carcinoma. Study of 95 patients. J Gastroenterol Hepatol 1990;5:616–626.
Katada K, Anno H, Takeshita G, Ogura Y, Koga S, Ida Y, Nonomura K, Kanno T, Ohashi A, Sata S, Shibata Y. Development of real-time CT fluoroscopy. Nippon Acta Radiologica 1994;54:1172–1174.
Takayasu K, Moriyama N, Muramatsu Y, Makuuchi M, Hasegawa H, Okazaki N, Hirohashi S. The diagnosis of small hepatocellular carcinomas: efficacy of various imaging procedures in 100 patients. AJR 1990;155:49–54.
Katada K, Anno H, Ogura Y, Koga S, Ida Y, Shibata Y. Early clinical experience with real-time CT fluoroscopy. Radiology 1994;193 (suppl):339 (abstract 3).
Ebara M, Kita K, Sugiura N, Yoshikawa M, Fukuda H, Ohto M, Kondo F, Kondo Y. Therapeutic effectic effect of percutaneous ethanol injection on small hepatocellular carcinoma: evaluation with CT. Radiology 1995;195:371–377.
Yamaguchi K, Kakinohana Y, Shinzato S, Asai T, Saginoya T, Nakano M. Measurement of radiation exposure dose in CT fluoroscopy. J Med Imaging Inf 1996;28:609–612.
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Furuse, J., Satake, M., Iwasaki, M. et al. Percutaneous ethanol injection under interventional radiographic computed tomography-fluoroscopic guidance for the treatment of small hepatocellular carcinomas. Int J Clin Oncol 3, 102–107 (1998). https://doi.org/10.1007/BF02492856
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DOI: https://doi.org/10.1007/BF02492856