Premium
Radiofrequency ablation for hepatocellular carcinoma: Clinical value of ultrasound–ultrasound overlay fusion for optimal ablation and local controllability
Author(s) -
Minami Yasunori,
Minami Tomohiro,
Takita Masahiro,
Hagiwara Satoru,
Ida Hiroshi,
Ueshima Kazuomi,
Nishida Naoshi,
Kudo Masatoshi
Publication year - 2020
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.13407
Subject(s) - radiofrequency ablation , ablation , medicine , hepatocellular carcinoma , overlay , ablative case , ultrasound , nuclear medicine , radiology , surgery , computer science , radiation therapy , programming language
Aim To retrospectively investigate the potential benefit of ultrasound–ultrasound (US‐US) overlay fusion guidance for local controllability of radiofrequency ablation (RFA) in the treatment of hepatocellular carcinoma (HCC). Methods Patients ( n = 101) with 121 HCCs (mean ± SD, 1.8 ± 0.7 cm) who underwent RFA guided by US‐US overlay fusion were included in the retrospective study. By overlaying pre/postoperative US, the tumor image could be projected onto the ablative hyperechoic zone. The ablative margin could thereby be evaluated three‐dimensionally during the RFA procedure. As a control group, all 325 patients with 453 HCCs who underwent conventional RFA during the same study period were selected. Results The total number of RF needle insertions per tumor for ablation was significantly more in the US overlay fusion group (mean 1.9 vs. 1.2; P < 0.01). The technical success rates of ablation after a single session were 100% (101/101) and 96.6% (314/325) for the US overlay fusion group and the control group, respectively. For early assessment of RFA response, 5‐mm safety margins were achieved in 89.3% (108/121) and 47.0% (213/453) of nodules in the US overlay fusion group and the control group, respectively ( P < 0.01). During the follow‐up period (median 19 months), the 2‐year local tumor progression rates were 0.8% (1/121) and 6.0% (27/453) in the US overlay fusion group and the control group, respectively ( P = 0.022, log–rank test). Conclusions US‐US overlay fusion guidance can be highly effective for safety margin achievement in RFA for HCC, providing a lower risk of local tumor progression.