One-lung ventilation for percutaneous thermal ablation of liver tumors in the hepatic dome

Figures & data

Table 1. Baseline characteristics of patients and lesions.

Characteristics	Value
Gender (male/female)	57/7
Age (years)	58 ± 11
Diagnosis (hepatocellular carcinoma/metastasis)	60/4
Cirrhosis (yes/no)	54/10
Reason for cirrhosis (HBV/HCV/alcoholic/none)	51/2/1/10
Maximum diameter (mm)	18 ± 7
Partially visible/invisible	39/36
Location (S1/2/3/4/5/6/7/8)	4/3/0/5/4/0/16/43
Anterior dome/posterior dome	37/38

HBV: hepatitis B virus; HCV: hepatitis C virus.

Figure 1. A 66-year-old male. (A) Contrast-enhanced MRI indicated a recurrent hepatocellular carcinoma located in segment 4/8 with a maximum diameter of 17 mm. (B) The nodule was partially visible and partially affected by the pulmonary gas. (C and D) The nodule became completely visible after one-lung ventilation and contrast-enhanced ultrasound confirmed the target location. (E) Thermal ablation was performed and immediate contrast-enhanced ultrasound demonstrated that the avascular zone covered the index tumor completely. (F) Contrast-enhanced MRI one month after the ablation procedure confirmed the technical efficacy.

Figure 2. A 48-year-old male. (A) Contrast enhanced MRI indicated a recurrent hepatocellular carcinoma of 12 mm in segment 7. (B) The nodule was completely invisible because of the pulmonary gas. (C) The nodule became completely visible after one-lung ventilation. (D) Thermal ablation was performed and immediate contrast-enhanced ultrasound demonstrated no hyper-enhancement of the tumor. (E) Contrast-enhanced MRI one month after the ablation procedure confirmed the technical efficacy.

Table 2. Visibility scores before and after one-lung ventilation.

Before one-lung ventilation	After one-lung ventilation	No. of lesions
1 score	2 score	10 (30.3%)
	3 score	23 (69.7%)
2 score	2 score	5 (13.5%)
	3 score	32 (86.5%)

The visibility score grading of tumors: 1. Completely invisible due to the pulmonary gas; 2. Partially visible and partially affected by the pulmonary gas; 3. Clearly visible of the whole tumor.