Clinical value of ultrasound fusion imaging for the thermal ablation of 3-5 cm hepatocellular carcinoma

Abstract

Objective To investigate the effectiveness and safety of thermal ablation of patients with 3-5 cm hepatocellular carcinoma (HCC) under the assistance of ultrasound fusion imaging. Methods From December 2010 to December 2017, 76 HCC patients with 78 medium-size (3-5 cm) lesions who underwent radiofrequency ablation (RFA) or microwave ablation (MWA) were included in the study.Ultrasound fusion imaging was used to assist the ablation procedures and assess the technical success immediately, then guided supplementary ablation. Contrast-enhanced CT/MR was performed one month after ablation to assess the technique efficacy rate. The complication, local tumor progression (LTP) rate were followed up. Results According to the ultrasound fusion imaging evaluation, 24 lesions (30.8%, 24/78) received supplementary ablation immediately during the ablation procedure. Seventy-one of 78 liver tumors were evaluated to achieve 5 mm ablative margin while the other 7 liver tumors were not achieved. There were no ablation-related deaths, and the major complication rate was 6.6%(5/76). The technique efficacy rate was 100%(78/78) according to the contrast-enhanced CT/MR one-month later. Patients were followed up from 6 to 79 months with a median time of 22 months. LTP occurred in 4 lesions and the LTP rate was 5.1% (4/78). Conclusions With the assistance of ultrasound fusion imaging, thermal ablation of medium-sized HCC is effective and safe which could achieve a higher technique efficacy rate and a lower LTP rate. Key words: Ultrasonography; Liver neoplasms; Fusion imaging; Thermal ablation