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World J Hepatol. Jul 8, 2017; 9(19): 840-849
Published online Jul 8, 2017. doi: 10.4254/wjh.v9.i19.840
Imaging guided percutaneous interventions in hepatic dome lesions: Tips and tricks
Avinash Kambadakone, Vinit Baliyan, Hamed Kordbacheh, Raul N Uppot, Ashraf Thabet, Debra A Gervais, Ronald S Arellano
Avinash Kambadakone, Vinit Baliyan, Hamed Kordbacheh, Raul N Uppot, Ashraf Thabet, Debra A Gervais, Ronald S Arellano, Harvard Medical School, Abdominal Imaging and Interventional Radiology, Massachusetts General Hospital, Boston, MA 02114, United States
Author contributions: All authors contributed equally for concept, literature search and manuscript writing.
Conflict-of-interest statement: Nothing to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Avinash Kambadakone, MD, FRCR, Assistant Professor, Harvard Medical School, Abdominal Imaging and Interventional Radiology, Massachusetts General Hospital, White 270, 55 Fruit Street, Boston, MA 02114, United States. akambadakone@mgh.harvard.edu
Telephone: +1-617-6432009 Fax: +1-617-7264891
Received: March 3, 2017
Peer-review started: March 5, 2017
First decision: March 28, 2017
Revised: April 6, 2017
Accepted: April 23, 2017
Article in press: April 24, 2017
Published online: July 8, 2017
Abstract

Percutaneous hepatic interventions are generally safe given the fact that liver closely abuts the abdominal wall and hence it is easily accessible. However, the superior portion of liver, adjacent to the diaphragm, commonly referred as the “hepatic dome”, presents unique challenges for interventionists. Percutaneous access to the hepatic dome may be restricted by anatomical factors and special considerations may be required to avoid injury to the surrounding organs. The purpose of this review article is to discuss certain specific maneuvers and techniques that can enhance the success and safety of interventions in the hepatic dome.

Keywords: Hepatic dome, Radiofrequency ablation, Hepatocellular carcinoma, Percutaneous intervention

Core tip: Percutaneous interventions for lesions in the hepatic dome can be technically challenging. This review article discusses various maneuvers and techniques to safely access and treat lesions in this region.