학술논문

Radiofrequency ablation for hepatocellular carcinoma: Clinical value of ultrasound–ultrasound overlay fusion for optimal ablation and local controllability.
Document Type
Article
Source
Hepatology Research. Jan2020, Vol. 50 Issue 1, p67-74. 8p.
Subject
*CATHETER ablation
*HEPATOCELLULAR carcinoma
*CONTROLLABILITY in systems engineering
*CANCER invasiveness
*LOG-rank test
*ENDORECTAL ultrasonography
*SPINAL fusion
Language
ISSN
1386-6346
Abstract
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. [ABSTRACT FROM AUTHOR]