Liver Tumor Ablation: Real-time Monitoring with Dynamic CT

Rationale and Objectives. To determine whether incomplete contact of ethanol with tumor limits the success of percutaneous ethanol injection therapy. Materials and Methods. Percutaneous ethanol injection was performed in seven normal New Zealand white rabbits and 18 rabbits with 1-3-cm liver tumors 10-14 days after percutaneous implantation of suspended tumor cells. A 3-5-mL dose of ethanol was injected at a rate of 0.2 mL/sec either into normal liver remote from large vessels or directly into tumor. During and immediately after injection, axial, 2-mm-thick, contrast material-enhanced computed tomography scans were obtained at each of three levels every 9 seconds. Results. In normal animals, virtually all injected ethanol tracked to the hepatic capsule. As ethanol was injected into tumors, peripheral tracking, similar to that seen in normal livers, or extratumoral puddling was observed. Ethanol-tumor contact was incomplete in 16 of 18 animals (89%). Histopathologic analysis showed incomplete tumor necrosis. Conclusion. In this model of hepatic carcinoma metastasis, the tumor failed to hold sufficient ethanol for successful ablation by means of percutaneous ethanol injection therapy.