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Combined ultrasound/computed tomography guidance in percutaneous radiofrequency ablation after transarterial chemoembolization for hepatocellular carcinoma in the hepatic dome

Authors Kan X, Wang Y, Han P, Yao Q, Qian K, Xiong B, Zheng C

Received 13 April 2019

Accepted for publication 28 July 2019

Published 15 August 2019 Volume 2019:11 Pages 7751—7757

DOI https://doi.org/10.2147/CMAR.S212127

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr Antonella D'Anneo


Xuefeng Kan,*,1,2 Yong Wang,*,1–3 Ping Han,1,2 Qi Yao,1,2 Kun Qian,1,2 Bin Xiong,*,1,2 Chuansheng Zheng*,1,2

1Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; 2Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China; 3Department of Vascular and Interventional Radiology, The Second Affiliated Hospital of Hainan Medical University, Haikou 570311, China

*These authors contributed equally to this work

Purpose: To assess the value of the combined ultrasound (US)/computed tomography (CT) guidance (US guidance was firstly used for puncture with the electrode needle to the site close to the tumor, and subsequently, CT guidance was used for precise positioning of the electrode tips) in percutaneous radiofrequency ablation (RFA) after transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) in the hepatic dome.
Methods: From January 1, 2013 to June 30, 2017, medical records of 65 patients with HCCs in the hepatic dome who received TACE treatment before RFA procedure were retrospectively analyzed. Among them, 34 patients with 35 liver tumors underwent percutaneous RFA under combined US/CT guidance, and 31 patients with 35 liver tumors received percutaneous RFA under CT guidance alone. The efficacy of combined US/CT-guided RFA was analyzed, and the procedure time and safety between the two groups were compared.
Results: In the combined US/CT-guided RFA group, the 1-, 3-, and 5-year local recurrence rates were 3%, 6%, 9%, respectively, and the 1-, 3-, and 5-year overall survival rates were 100%, 97%, 94%, respectively. The mean procedure time in the CT-guided RFA group was significantly longer than that of the combined US/CT-guided RFA group (P<0.001). Although the overall complication rates between the two groups were not statistically significant, there were no occurrences of RFA-related complications in the combined US/CT-guided RFA group. The incidence of postoperative adverse reaction of right upper quadrant pain in the CT-guided RFA group was greater than that of the combined US/CT-guided RFA group (P=0.01).
Conclusion: Percutaneous RFA under the combined US/CT guidance was helpful for HCC in the hepatic dome.

Keywords: radiofrequency ablation, hepatocellular carcinoma, hepatic dome, combined US/CT guidance, CT guidance

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