Computed tomography-guided percutaneous microwave ablation with artificial ascites for problematic hepatocellular tumors

Wang, Yongzheng; Zhang, Lili; Li, Yuliang; Wang, Wujie

doi:10.1080/02656736.2020.1736649

Cited by 15 publications

(7 citation statements)

References 46 publications

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“…Considering the high risk of thermal injury to the diaphragm around the tumor after MWA, precautionary measures should be taken to avoid collateral damage to adjacent organs. Results of a previous study suggested that the establishment of artificial ascites and/or pleural effusion was equivalent to the formation of a barrier zone, which may separate the adjacent blood vessels, liver and diaphragm from thermal ablation (12)(13)(14). The barrier zone may reduce heat energy conduction and avoid thermal injury, thereby protecting the diaphragm, lung tissues and its internal blood vessels.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous microwave ablation‑induced hepatic artery‑pulmonary artery fistula: A rare case report

2023

Mol Clin Oncol

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Microwave ablation (MWA) is safe and effective for patients with unresectable primary and secondary hepatic tumors, but it also has a series of complications. The present study reported on the case of a 60-year-old male patient with progression of solitary liver metastasis who underwent multiple courses and lines of chemotherapy. Hepatic artery-pulmonary artery fistula due to thermal damage may occur after MWA for hepatic tumor adjacent to the diaphragm. Symptomatic improvement was achieved by trans-arterial embolization and hepatic arteriography indicated complete occlusion of the fistula. The postoperative course was uneventful and the patient was discharged three days later. This rare complication should be taken into consideration in clinical treatment.

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Section: Discussionmentioning

confidence: 99%

Percutaneous microwave ablation‑induced hepatic artery‑pulmonary artery fistula: A rare case report

2023

Mol Clin Oncol

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“…When compared with normal saline, hydrodissection with 5% dextrose in water is more protective from adjacent organ injury in radiofrequency ablation; however, either 5% dextrose or normal saline can be used during microwave ablation. 68 69 Faintly radiopaque contrast (2% solution of iodinated contrast in normal saline) is used to aid in the visualization of at-risk anatomy during hydrodissection. While the attenuation difference between hydrodissection fluid and nontarget anatomy is optimized with this technique, there is potential for masking visualization of bleeding given similar densities of acute blood products and dilute contrast.…”

Section: Procedural Detailsmentioning

confidence: 99%

Microwave Ablation of Hepatocellular Carcinoma and Liver Metastases: Challenges, Opportunities, and Future Directions

Stratchko

Knavel-Koepsel

Ziemlewicz

et al. 2022

Digestive Disease Interventions

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Chronic liver disease predisposes patients to the development of hepatocellular carcinoma (HCC), and the degree of liver dysfunction helps dictate the management of patients with primary hepatic malignancy. Percutaneous ablation is an increasingly utilized treatment modality for patients with hepatocellular carcinoma who are poor surgical candidates, particularly when treatment goals include sparing hepatic parenchyma in the setting of hepatic dysfunction. Various thermal and non-thermal ablation modalities have historically been used to treat HCC. With advances in ablation technology, modern microwave (MW) ablation systems have become increasingly utilized in HCC as well as hepatic metastatic disease management due to larger and more predictable ablation zones. The evolution of ablation technology has resulted in the growth of ablation as a safe and effective treatment option for patients with primary and secondary liver tumors.

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“…At present, there are X-ray, ultrasound, magnetic resonance imaging (MRI), and computed tomography (CT) for the clinical diagnosis of ascites. X-ray and ultrasound have poor diagnostic effect on ascites and cannot make a definite diagnosis [ 12 ]. Although ordinary CT can detect the occurrence of ascites with high resolution, it cannot judge the nature of ascites.…”

Section: Introductionmentioning

confidence: 99%

Reconstruction Algorithm-Based CT Imaging for the Diagnosis of Hepatic Ascites

Zhang

Diao

et al. 2022

Computational and Mathematical Methods in Medicine

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The study was aimed at exploring the diagnostic value of artificial intelligence reconstruction algorithm combined with CT image parameters on hepatic ascites, expected to provide a reference for the etiological evaluation of clinical abdominal effusion. Specifically, the adaptive iterative hard threshold (AIHT) algorithm for CT image reconstruction was proposed. Then, 100 patients with peritoneal effusion were selected as the research subjects. After 8 cases were excluded, the remaining was divided into 50 cases of the S1 group (hepatic ascites) and 42 cases of the D0 group (cancerous peritoneal effusion). Gemstone energy spectrum CT scanning was performed on all patients, and CT image parameters of the two groups were compared. It was found that CT value of mixed energy, CT value of 60-100 KeV single energy, concentration value of water (calcium), concentration value of water (iodine), and slope of energy spectrum curve in the S1 group were significantly lower than those in the D0 group ( P < 0.05 ). The effective atomic number in the S1 group was significantly higher than that in the D0 group ( P < 0.05 ). Of the 50 patients in the S1 group, 3 (6%) had an ascending and 47 (94%) had a descending spectral curve. Of the 42 patients in the D0 group, 37 (88.1%) had an ascending and 5 (11.9%) had a descending spectral curve. The sensitivity and specificity of water (iodine) were 0.927 and 0.836, respectively. The sensitivity and specificity of water (calcium) were 0.863 and 0.887, respectively. For different scan ranges ([0,90]; [0,120]), root mean square error (RMSE) of AIHT reconstructed image was significantly smaller than that of traditional algorithm, while peak signal-to-noise ratio (PSNR) was opposite. The differences were statistically significant ( P < 0.05 ). In conclusion, AIHT-based CT images can better display the distribution of hepatic ascites, and the parameters of CT value, effective atomic number, water (iodine), water (calcium), and spectral curve can all provide help for the identification of hepatic ascites. Especially, water (iodine) and water (calcium) demonstrated high diagnostic performance of hepatic ascites.

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Computed tomography-guided percutaneous microwave ablation with artificial ascites for problematic hepatocellular tumors

Cited by 15 publications

References 46 publications

Percutaneous microwave ablation‑induced hepatic artery‑pulmonary artery fistula: A rare case report

Percutaneous microwave ablation‑induced hepatic artery‑pulmonary artery fistula: A rare case report

Microwave Ablation of Hepatocellular Carcinoma and Liver Metastases: Challenges, Opportunities, and Future Directions

Reconstruction Algorithm-Based CT Imaging for the Diagnosis of Hepatic Ascites

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