Efficacy of Fusion Imaging and Cone-Beam Computed Tomography-Guided Radiofrequency Ablation for Hepatocellular Carcinoma Poorly Visualized on Ultrasonography.

IF 1.8 3区医学 Q3 ONCOLOGY

Oncology Pub Date : 2025-05-26 DOI:10.1159/000546427

Keizo Kato, Hiroshi Abe, Makiko Ika, Yuhi Sakamoto, Mizuki Takeuchi, Shingo Komazaki, Shinichiro Takeda, Sadahiro Ito, Shohei Shimizu, Ryota Matsuo

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引用次数: 0

Abstract

Introduction: Radiofrequency ablation (RFA) generally involves the insertion of a radiofrequency electrode into the hepatocellular carcinoma (HCC) nodule under ultrasonography (US) guidance. However, the procedure is often not feasible for patients whose HCC is undetectable on conventional US. Advances in imaging technology, such as fusion imaging (FI) and cone-beam computed tomography (CBCT), may enhance treatment precision and efficacy for these challenging cases. This study assessed the efficacy of RFA guided by FI and CBCT in managing HCC poorly visualized on US.

Methods: HCC nodules were classified into GOOD (clearly delineated), POOR (poorly delineated), and NONE (undetectable) based on US visualization. All nodules underwent RFA guided by FI and CBCT either in combination with transcatheter arterial chemoembolization (TACE) or without TACE. The technical success rate and local tumor progression post-RFA were evaluated using dynamic contrast-enhanced imaging. Between-group differences were analyzed retrospectively.

Results: A total of 420 patients with 595 HCC nodules were enrolled. Complete ablation rates were 91.4%, 94.9%, and 86.2% in the GOOD, POOR, and NONE groups, respectively. For nodules with over 50% lipiodol accumulation, the complete ablation rates were 91.5%, 96.5%, and 88.8%; for those with less than 50% lipiodol accumulation, they were 95.5%, 100%, and 62.5%; and for those without lipiodol accumulation, they were 89.5%, 77.8%, and 82.4% in the GOOD, POOR, and NONE groups, respectively. Significant factors associated with complete ablation included larger nodule size and lipiodol accumulation. Cumulative local tumor progression rates at 1 year were 4.5%, 0%, and 3.8%, with no significant differences among groups.

Conclusion: FI and CBCT guidance effectively achieve local control for HCC, including nodules poorly visualized on US, with outcomes comparable to US-visible nodules, especially for those with lipiodol accumulation.

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融合显像和锥形束计算机断层引导射频消融治疗超声显像差的肝细胞癌的疗效。

简介：射频消融（RFA）通常涉及在超声（US）引导下将射频电极插入肝细胞癌（HCC）结节。然而，对于常规超声检查无法检测到HCC的患者，该手术通常是不可行的。成像技术的进步，如融合成像（FI）和锥束计算机断层扫描（CBCT），可能会提高这些具有挑战性的病例的治疗精度和疗效。本研究评估了FI和CBCT引导下RFA治疗超声显像差的肝癌的疗效。方法：根据超声成像将肝细胞癌结节分为GOOD（清晰划分）、POOR（划分不清）和NONE（未检测到）。所有结节均在FI和CBCT引导下行RFA，联合经导管动脉化疗栓塞（TACE）或不联合TACE。采用动态对比增强成像技术评估rfa后的技术成功率和局部肿瘤进展。回顾性分析组间差异。结果：共纳入420例595个HCC结节。GOOD组、POOR组和NONE组的完全消融率分别为91.4%、94.9%和86.2%。对于脂醇积累超过50%的结节，完全消融率分别为91.5%、96.5%和88.8%；脂醇积累小于50%者分别为95.5%、100%和62.5%；对于没有脂醇积累的患者，GOOD、POOR和NONE组分别为89.5%、77.8%和82.4%。与完全消融相关的重要因素包括较大的结节大小和脂醇积累。1年累积局部肿瘤进展率分别为4.5%、0%和3.8%，组间无显著差异。结论：FI和CBCT引导有效地实现了对肝癌的局部控制，包括US上不可见的结节，其结果与US上可见的结节相当，特别是对于那些有脂醇积累的结节。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oncology 医学-肿瘤学

CiteScore

6.00

自引率

2.90%

发文量

审稿时长

6-12 weeks

期刊介绍： Although laboratory and clinical cancer research need to be closely linked, observations at the basic level often remain removed from medical applications. This journal works to accelerate the translation of experimental results into the clinic, and back again into the laboratory for further investigation. The fundamental purpose of this effort is to advance clinically-relevant knowledge of cancer, and improve the outcome of prevention, diagnosis and treatment of malignant disease. The journal publishes significant clinical studies from cancer programs around the world, along with important translational laboratory findings, mini-reviews (invited and submitted) and in-depth discussions of evolving and controversial topics in the oncology arena. A unique feature of the journal is a new section which focuses on rapid peer-review and subsequent publication of short reports of phase 1 and phase 2 clinical cancer trials, with a goal of insuring that high-quality clinical cancer research quickly enters the public domain, regardless of the trial’s ultimate conclusions regarding efficacy or toxicity.