Percutaneous radiofrequency ablation of hepatic tumors against the diaphragm: Frequency of diaphragmatic injury

Purpose: To retrospectively determine the frequency of diaphragmatic injury when percutaneous hepatic radiofrequency (RF) ablation is performed adjacent to the diaphragm. Materials and Methods: Institutional Review Board approval was obtained for our HIPAA-compliant study. Informed consent for the ablation procedure and for use of related data for future research was obtained from each patient. A retrospective review was conducted of 215 patients undergoing percutaneous RF ablation of hepatic tumors. Twenty-nine patients (21 men and eight women; age, 41–89 years) were identified with tumors abutting the diaphragm. Episodes of right shoulder pain were recorded. A panel of radiologists blinded to the patients' clinical histories reviewed their imaging for evidence of diaphragmatic injury and ablation success. A generalized estimating equation model and the Fisher exact test were used for statistical analysis. Results: The 29 patients had a total of 33 tumors abutting the diaphragm. Tumor size was 1.3–5.5 cm...