Image-Guided Microwave Ablation of Hepatocellular Carcinoma (≤5.0 cm): Is MR Guidance More Effective Than CT Guidance?

Abstract BackgroundPercutaneous tumor ablation is usually performed using computed tomography (CT) or ultrasound (US) guidance, although reliable visualization of the target tumor may be challenging. MRI guidance can provide more reliable visualization of the target tumor and allow for multiplanar capabilities, making it the modality of choice. Due to the lack of comparative studies of microwave ablation(MWA) guided by different images. This study retrospectively compared the effectiveness of computed tomography (CT)-guided versus magnetic resonance (MR)-guided MWA for hepatocellular carcinoma (HCC≤5.0 cm). MethodsIn this retrospective study, 47 patients and 54 patients received MWA under the guidance of CT and MR, respectively. The inclusion criteria were a single HCC≤5.0 cm or a maximum of three. The local tumor progression (LTP), overall survival (OS), prognostic factors for local progression, and safety of this technique were assessed.ResultsAll procedures were technically successful. The complication rates of the two groups were significantly different with respect to liver abscess and pleural effusion (P<0.05). The mean LTP was 44.264 months in the CT-guided group versus 47.745 months in the MR-guided group of HCC (P = 0.629, log-rank test). The mean OS was 56.772 months in the patients who underwent the CBCT-guided procedure versus 58.123 months in those who underwent the MR-guided procedure (P = 0.630, log-rank test). Multivariate Cox regression analysis further illustrated that tumor diameter (<3 cm) and the number of lesions (single) were important factors affecting LTP and OS.ConclusionsCT-guided and MR-guided MWA are safe and effective in the treatment of HCC with a diameter of less than 5 cm. Furthermore, MR-guided MWA could reduce the incidence of complications.