Lim Sanghyeok, Lee Min Woo, Rhim Hyunchul, Cha Dong Ik, Kang Tae Wook, Min Ji Hye, Song Kyoung Doo, Choi Seo-Youn, Lim Hyo K
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Republic of Korea.
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Republic of Korea.
J Vasc Interv Radiol. 2014 Feb;25(2):307-14. doi: 10.1016/j.jvir.2013.10.025. Epub 2013 Dec 5.
To evaluate the incidence and causes of mistargeting after fusion imaging-guided percutaneous radiofrequency (RF) ablation of hepatocellular carcinomas (HCCs).
Between September 2011 and March 2013, 955 HCCs in 732 patients were treated with percutaneous RF ablation. Among them, ablation of 551 HCCs was accomplished under fusion imaging guidance, and seven mistargetings were noted in seven patients (male-to-female ratio = 6:1; mean age, 60.1 y; range, 47-73 y). The incidence of mistargeting and the cause of liver disease in the patients with mistargeting were evaluated. The causes of mistargeting were assessed according to the following classification: small size of HCC, subcapsular location, subphrenic location, confusion with pseudolesions, poor conspicuity of HCC, poor sonographic window, and poor electrode path.
The incidence of mistargeting after fusion imaging-guided RF ablation was 1.3% (7 of 551). All patients with mistargeting were hepatitis B virus carriers. The most common cause of mistargeting was the small size of HCC (100%; 7 of 7), followed by confusion with surrounding pseudolesions (85.7%; 6 of 7), subcapsular (71.4%; 5 of 7) and subphrenic locations (71.4%; 5 of 7), poor conspicuity of the HCC (71.4%; 6 of 7), poor sonographic window (28.6%; 2 of 7), and poor electrode path (28.6%; 2 of 7).
The incidence of mistargeting after fusion imaging-guided RF ablation was 1.3%. The most common cause of mistargeting was the small size of HCC, followed by confusion with surrounding pseudolesions, subcapsular and subphrenic locations, and poor conspicuity of the HCC.
评估融合成像引导下经皮射频（RF）消融肝细胞癌（HCC）后误靶的发生率及原因。
2011年9月至2013年3月期间，对732例患者的955个HCC进行了经皮RF消融治疗。其中，551个HCC的消融在融合成像引导下完成，7例患者出现7次误靶（男女比例=6:1；平均年龄60.1岁；范围47 - 73岁）。评估了误靶的发生率以及误靶患者的肝病病因。根据以下分类评估误靶原因：HCC体积小、位于包膜下、位于膈下、与假病灶混淆、HCC显示不清、超声窗不佳以及电极路径不佳。
融合成像引导下RF消融后误靶的发生率为1.3%（551例中的7例）。所有误靶患者均为乙型肝炎病毒携带者。误靶最常见的原因是HCC体积小（100%；7例中的7例），其次是与周围假病灶混淆（85.7%；7例中的6例）、位于包膜下（71.4%；7例中的5例）和膈下位置（71.4%；7例中的5例）、HCC显示不清（71.4%；7例中的6例）、超声窗不佳（28.6%；7例中的2例）以及电极路径不佳（28.6%；7例中的2例）。
融合成像引导下RF消融后误靶的发生率为1.3%。误靶最常见的原因是HCC体积小，其次是与周围假病灶混淆、位于包膜下和膈下位置以及HCC显示不清。
