Security and efficiency of percutaneous microwave ablation by combining computer tomography- with ultrasound-guided in patients with BCLC-A1-3 hepatocellular carcinoma

Background : To evaluate prospectively security and efficiency of percutaneous microwave ablation (MWA) by combining computer tomography (CT)- with ultrasound (US)-guided of in patients with BCLC-A1-3 hepatocellular carcinoma (HCC ). Methods : We studied 88 consecutive patients with single HCC who were treated with transcather hepatic arterial chemoembolization (TACE), patients were divided into 3 groups at random by using draw lots 1 week after TACE, combination group (34 cases) received MWA under the guidance of CT and US, while single group (CT group 30 cases, US group 24 cases) received MWA under the guidance of CT or US alone.1 month,3 months,6months and12 months after the procedure, contrast-enhanced MRI scan were performed in all cases. Study endpoints included treatment time, puncture time, local recurrence rate and adverse events. Results : A total of 88 lesions were radically treated with MWA after TACE. The median diameter of the lesion was 3.1(1.5-4.2) cm. The mean treatment time, puncture time were 38.6 (30-45) min, 36.7 (30-47) min, and 1.2 (1-2), 1.1 (1-2) in the combination group and US group, which were significantly inferior to CT group (45.8 minutes and 4.2); Local recurrence rate was 5.9% in the combination group, which was significantly inferior to US group (16.7%).Grade C complication rates occurred in the combination group was 5.9%, while it was 13.3% and 8.3% in CT group and US group, there was statistically significant between combination group and CT group ( P <0.05). Conclusions : Using CT- and US-guided microwave ablation in patients with BCLC-A1-3 hepatocellular carcinoma appeared to be much better in security and efficiency than that under the guidance of CT or US alone.