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Gan To Kagaku Ryoho 1998 Jul;25(9):1254-1258
Non-real-time computed tomography-guided percutaneous ethanol
injection therapy for hepatocellular carcinoma undetectable by ultrasonography.
[Article in Japanese]
Ueda K, Ohkawara T, Minami M, Sawa Y, Morinaga O, Kohli Y, Ohkawara Y
Dept. of Internal Medicine, Aiseikai Yamashina Hospital.
The purpose of this study was to evaluate the feasibility of non-real-time
CT-guided percutaneous ethanol injection therapy (PEIT) for hepatocellular carcinoma
(HCC, 37 lesions) untreatable by ultrasonography-guided (US)-PEIT. The HCC lesion
was localized on the lipiodol CT image with a graduated grid system. We advanced
a 21 G or 22 G needle in a stepwise fashion with intermittent localization scans
using a tandem method to position the tip of the needle in the lesion. Ethanol
containing contrast medium was injected with monitoring scans obtained after
incremental volumes of injection, until perfusion of the lesion was judged to
be complete. A total of 44 CT-PEIT procedures were performed. The average number
of needle passes from the skin to the liver in each CT-PEIT procedure was 2.3,
the average amount of ethanol injected was 14.4 ml, and the average time required
was 49.3 minutes. Complete perfusion of the lesion by ethanol on monitoring
CT images was achieved in all lesions with only a single or double CT-PEIT procedure
without severe complication. Local recurrence was detected only in 5 lesions.
At present, it is more time-consuming to perform CT-PEIT than US-PEIT because
conventional CT guidance is not real-time imaging. However, it is expected that
this limitation of CT-PEIT will be overcome in the near future with the introduction
of CT fluoroscopy. In conclusion, CT-PEIT should prove to be a feasible, acceptable
treatment for challenging cases of HCC undetectable by US.
PMID: 9703802, UI: 98369425
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