Real-time US-CT/MR fusion imaging for percutaneous radiofrequency ablation of hepatocellular carcinoma.
J Hepatol
; 66(2): 347-354, 2017 02.
Article
in En
| MEDLINE
| ID: mdl-27650284
ABSTRACT
BACKGROUND & AIMS:
Although ultrasonography (US) guided radiofrequency ablation (RFA) is a commonly used treatment option for early hepatocellular carcinoma (HCC), inconspicuous tumors on US limits its feasibility. Thus, we prospectively determined whether real-time US-CT/MR fusion imaging can improve the technical feasibility of RFA compared with B-mode US, and help predict local tumor progression after RFA in patients with HCC.METHODS:
A total of 216 patients with 243 HCCs ⩽5cm referred for RFA were prospectively enrolled. Prior to RFA, the operators scored the visibility of tumors, and technical feasibility on a 4-point scale at both B-mode US and fusion imaging. RFA was performed with a switching monopolar system using a separable cluster electrode under fusion imaging guidance. Technique effectiveness, local tumor progression and intrahepatic remote recurrences were evaluated.RESULTS:
Tumor visibility and technical feasibility were significantly improved with fusion imaging compared with B-mode US (p<0.001). Under fusion imaging guidance, the technique effectiveness of RFA for invisible tumors on B-mode US was similar to those for visible tumors (96.1% vs. 97.6%, p=0.295). Estimated cumulative incidence of local tumor progression at 24months was 4.7%, and previous treatment for other hepatic tumors (p=0.01), higher expected number of electrode insertions needed and lower technical feasibility scores (p<0.01) on fusion imaging were significant negative predictive factors for local tumor progression.CONCLUSION:
Real-time fusion imaging guidance significantly improved the tumor visibility and technical feasibility of RFA in patients with HCCs compared with B-mode US, and low feasibility scores on fusion imaging was a significant negative predictive factor for local tumor progression. LAYSUMMARY:
US/CT-MR fusion imaging guidance improved the tumor visibility and technical feasibility of RFA in patients with HCCs. In addition, fusion imaging guided RFA using multiple electrodes demonstrated a high technique effectiveness rate and a low local tumor progression rate during mid-term follow-up. Clinical trial number ClinicalTrials.gov number, NCT02687113.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Catheter Ablation
/
Carcinoma, Hepatocellular
/
Surgery, Computer-Assisted
/
Multimodal Imaging
/
Liver Neoplasms
Type of study:
Guideline
/
Prognostic_studies
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Asia
Language:
En
Journal:
J Hepatol
Journal subject:
GASTROENTEROLOGIA
Year:
2017
Document type:
Article
Affiliation country:
Corea del Sur