Radiofrequency ablation for hepatocellular carcinoma: Clinical value of ultrasound-ultrasound overlay fusion for optimal ablation and local controllability.
Radiofrequency ablation for hepatocellular carcinoma: Clinical value of ultrasound-ultrasound overlay fusion for optimal ablation and local controllability.
复制标题
肝细胞癌射频消融：超声-超声叠加融合对于最佳消融和局部可控性的临床价值。
DOI：
10.1111/hepr.13407
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Kudo M.
中科院分区：
文献类型：
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作者：
Minami Y;Minami T;Takita M;Hagiwara S;Ida H;Ueshima K;Nishida N;Kudo M.
目的回顾性研究超声-超声（US-US）叠加融合引导下射频消融（RFA）治疗肝细胞癌（HCC）的局部可控性的潜在益处。方法回顾性研究纳入了101例患者（n= 101），121例HCC（平均值± SD，1.8 ± 0.7 cm）接受US-US叠加融合引导下RFA。通过叠加术前/术后US，肿瘤图像可以投影到消融高回声区。因此，可以在RFA手术期间对消融边缘进行三维评价。作为对照组，所有325例患者453肝癌谁在同一研究期间进行了传统的RFA selected.ResultsThe射频针插入的总数，每个肿瘤消融显着更多的美国覆盖融合组（平均1.9与1.2;P< 0.01）。超声覆盖融合组和对照组单次消融后的技术成功率分别为100%（101/101）和96.6%（314/325）。对于RFA反应的早期评估，US覆盖融合组和对照组中分别有89.3%（108/121）和47.0%（213/453）的结节达到了5 mm的安全边界（P< 0.01）。随访期间（中位19个月），US覆盖融合组和对照组的2年局部肿瘤进展率分别为0.8%（1/121）和6.0%（27/453）（P= 0.022，对数秩检验）。结论US-US叠加融合引导可高度有效地实现HCC RFA的安全裕度，从而降低局部肿瘤进展的风险。
AimTo 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).MethodsPatients (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.ResultsThe 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).ConclusionsUS‐US overlay fusion guidance can be highly effective for safety margin achievement in RFA for HCC, providing a lower risk of local tumor progression.