Abstract
Introduction: Sonography is the most universally used imaging technique for planning and performing thermal ablation in Hepatocellular carcinoma patients due to its efficiency and safety. However, the presence of HCC nodules that are hardly visible on traditional sonography is a major drawback to its use during thermal ablation. Real-time image fusion (fusion imaging) or real-time virtual sonography is a new technology that has been developed. Aim: To determine the value of fusion/navigation guided percutaneous thermal ablation in the management of hepatocellular carcinoma that has poor conspicuity at conventional sonography. Subjects and Methods: This study included 70 HCC patients (BCLC A and B). Percutaneous radiofrequency ablation was done via real-time image fusion for 14 patients with poorly visible HCC nodules (study group), while Percutaneous radiofrequency ablation was done via traditional sonography for 56 patients with HCC nodules (control group). Results: The median time to reach the tumor was significantly shorter by using fusion navigation technique (P = 0.034). By using fusion navigation technique 92% of the lesions were completely ablated while 55% only were completely ablated by using ultrasonography (P = 0.014). One year after the procedure , by using fusion navigation technique 92% of the patients had complete response and only 55% of the patients had complete response by using conventional ultrasonography (P = 0.011). The survival distributions for both interventions were statistically significantly different, χ2 = 10.12, P = 0.001. Conclusion: Fusion imaging-guided percutaneous RFA is a reasonable and efficient treatment of patients with HCC undetectable by traditional ultrasonography.
Highlights
Sonography is the most universally used imaging technique for planning and performing thermal ablation in Hepatocellular carcinoma patients due to its efficiency and safety
Percutaneous radiofrequency ablation was done via real-time image fusion for 14 patients with poorly visible Hepatocellular carcinoma (HCC) nodules, while Percutaneous radiofrequency ablation was done via traditional sonography for 56 patients with HCC nodules
By using fusion navigation technique 92% of the lesions were completely ablated while 55% only were completely ablated by using ultrasonography (P = 0.014)
Summary
Sonography is the most universally used imaging technique for planning and performing thermal ablation in Hepatocellular carcinoma patients due to its efficiency and safety. Aim: To determine the value of fusion/navigation guided percutaneous thermal ablation in the management of hepatocellular carcinoma that has poor conspicuity at conventional sonography. Percutaneous radiofrequency ablation was done via real-time image fusion for 14 patients with poorly visible HCC nodules (study group), while Percutaneous radiofrequency ablation was done via traditional sonography for 56 patients with HCC nodules (control group). Conclusion: Fusion imaging-guided percutaneous RFA is a reasonable and efficient treatment of patients with HCC undetectable by traditional ultrasonography. Hepatocellular carcinoma (HCC) is considered one of the poorest prognostic solid cancer, representing about 90% of primary liver cancer It is the third most common cause of cancer related mortality worldwide. The sequences of chronic HCV infection [10] [11] include the development of liver cirrhosis [12] [13], end stage liver diseases [14] and the progression of HCC depending on different immunological factors and genetic susceptibility [15] [16] [17] [18]
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