case_images: PMC4683791_01
case_images: 60-year-old man presenting with liver tumor in the hepatic dome underwent MRI/CT of abdomen. (a) Axial MRI scan demonstrates a hepatocellular carcinoma nodule (white arrow) in the hepatic dome. (b) Preinterventional CT image shows the same nodule (white arrow) after contrast media injection.
case_images: JCIS-5-63-g002.jpg
case_images: PMC4683791_01_JCIS-5-63-g002.jpg
case_images: F1
case_images: A 60-year-old man presented with a hepatocellular nodule measuring 2.0 cm in the superior portion of segment VIII [Figure 1a]. A dynamic CT was obtained for identification of the target lesion and access planning [Figure 1b].
case_images: 60-year-old man presenting with a hepatocellular carcinoma in the hepatic dome. (a) Ultrasound image shows a 22G spinal needle (white solid arrows) crossing the parietal pleura (white thin arrows). (b) CT image confirms the needle position (white solid arrow) within the pleural space. (c) A single-lumen catheter (white solid arrows) was placed in the right pleural cavity, allowing large amount of air injection (white star). (d) Subsequently, a radiofrequency probe (white solid arrow) was introduced into the middle of the lesion to be treated, through a transpleural access.
case_images: JCIS-5-63-g003.jpg
case_images: PMC4683791_01_JCIS-5-63-g003.jpg
case_images: F2
case_images: B. Braun; Melsungen, Germany) was introduced to the right pleural cavity guided by ultrasound and CT [Figure 2a and b]. Teleflex Incorporated, Reading, PA, USA) was introduced by Seldinger technique [Figure 2c]. Another 600 cc of air was injected under continuous clinical monitoring and repeated CT scans. The artificial pneumothorax promoted separation of the lung parenchyma, allowing a transpleural access guided by CT [Figure 2d]. The RFA was performed by a single probe ACTC 2520 (Covidien Ltd., Dublin, Ireland).
case_images: 60-year-old man presenting with a hepatocellular carcinoma in the hepatic dome underwent percutaneous radiofrequency ablation. Follow-up (a) axial and (b) coronal MRI scans 2 months after the procedure demonstrated complete necrosis of the lesion (white solid arrows).
case_images: JCIS-5-63-g004.jpg
case_images: PMC4683791_01_JCIS-5-63-g004.jpg
case_images: F3
case_images: Follow-up MRI 2 months later demonstrated complete necrosis of the treated lesion [Figure 3].