Comparative Study of Application of Computed Tomography/Ultrasound and Computed Tomography Imaging Guidance Methods in the Microwave Ablation of Liver Cancer

Abstract

Purpose The aim of the study is to assess the clinical value of the combined computed tomography (CT)/ultrasound (US) guidance in microwave ablation (MWA) for hepatocellular carcinoma (HCC). Methods From July 16, 2016, to June 20, 2021, medical records of 150 HCC patients treated with MWA were retrospectively analyzed. Ninety-two patients with 115 liver tumors underwent MWA under combined CT/US guidance, and 58 patients with 73 liver tumors received MWA under CT guidance alone. The clinical efficacy of combined CT/US-guided MWA was analyzed. We compared the complications, procedure time, and CT scan times between the 2 groups. Results The total complete ablation rate and complete ablation rate of high-risk location tumors were significantly higher in the group treated with combined CT/US guidance (P = 0.0471 and P = 0.0347, respectively), the imaging guidance modality (odds ratio, 0.303; 95% confidence interval [CI], 0.095-0.970; P = 0.044) was an independent factor for ablation efficacy. These 2 groups also had significant differences in the procedure time (P = 0.0171), the incidence rate of pneumothorax (P = 0.0209), abdominal pain (P = 0.0196), nausea or vomiting (P = 0.0026), and intraoperative CT scan times (P < 0.001). The overall complication rates (P = 0.4023) and recurrence rates (P = 0.5063) between the 2 groups were not statistically significant. However, CT/US group has a better short-term progressive free survival (log-rank P = 0.103, Breslow P = 0.030). In multivariate analysis, guidance modality (hazard ratio, 0.586; 95% CI, 0.368-0.934; P = 0.025) and Barcelona Clinic Liver Cancer stage (hazard ratio, 2.933; 95% CI, 1.678-5.127; P < 0.001) were risk factor for progressive free survival. Conclusions Percutaneous MWA under the combined CT/US guidance for HCC can improve clinical benefits.