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We evaluated the safety margin in patients with hepatocellular carcinoma (HCC) in the hepatic dome who underwent computed tomography (CT)- or ultrasound (US)-guided radiofrequency ablation (RFA). Included in this single-center study were 46 patients with 56 HCCs in the hepatic dome undergoing RFA after transarterial chemoembolization from January 2009 to December 2016. Thirty were addressed with CT fluoroscopy and 26 with US guidance. The technical success, safety margin, and local tumor progression (LTP) were evaluated. Technical success rate was 100% in the CT-RFA and 84.6% in the US-RFA group ( p  = .04). The average safety margin was 4.8 mm in the CT-RFA and 3.0 mm in the US-RFA group ( p  = .01). There was no LTP among the HCCs with a safety margin &gt;3 mm achieved in 73.3% CT-RFA and 42.3% US-RFA group tumors ( p  = .03). Of the US-RFA group, six required additional RFA. There was no significant inter-group difference in LTP ( p  = .36). CT-guided RFA was superior to US-guided RFA with respect to the technical success rate and the acquisition of an appropriate safety margin in patients with HCC in the hepatic dome.

Safety margin for CT- and US-guided radiofrequency ablation after TACE of HCC in the hepatic dome