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Fig. 2 | BMC Cancer

Fig. 2

From: Artificial pneumothorax improves radiofrequency ablation of pulmonary metastases of hepatocellular carcinoma close to mediastinum

Fig. 2

Artificial pneumothorax adjuvant RFA of pulmonary metastases contiguous to the mediastinum (a 67-year-old man with a metastatic lesion in the superior lobe forepart of right lung). Tumor size, 1.5 × 1.2 cm. a Before ablation, chest CT imaging was performed to evaluate the anatomic relationship between tumor and peripheral cardiovascular structures. b Subsequently, a 22-G needle tip was used to create a puncture that reached the outer edge of pleura for injection of 1–2 ml saline. c The needle tip entered into the pleura, and the saline in the tube flowed into the cavity. d-e CO2 gas was administered gradually with a syringe until the tumor was separated from the mediastinum. f CT image during RFA showed the electrode inserted into the tumor and located away from the mediastinum by proxy of artificial pneumothorax. g The ablation zone gradually increased following the RFA procedure. h After RFA, the pulmonary texture around tumor showed a circular exudation shadow with ground-glass appearance on CT image. i Contrast enhanced CT image 1 month after RFA showed no enhancement of the ablated tumor contiguous to the mediastinum. j-l The size of ablated tumor decreased gradually after RFA during follow up at 3, 6, and 12 months, respectively

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