You Yujia, Long Yinglin, Yan Ronghua, Luo Liping, Zhang Man, Li Lu, Zeng Qingjing, Li Kai, Zheng Rongqin, Xu Erjiao
Department of Ultrasound, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
Department of Radiology, The Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, China.
Front Oncol. 2021 Mar 1;11:570312. doi: 10.3389/fonc.2021.570312. eCollection 2021.
To explore whether ablation safety could be improved by ultrasound (US)-magnetic resonance (MR) fusion imaging for hepatocellular carcinoma (HCC) proximal to the hilar bile ducts (HBDs) through a preliminary comparative study.
Between January 2014 and June 2019, 18 HCC nodules proximal to the HBDs were included in a US-MR fusion imaging-assisted radiofrequency ablation (RFA) group (study group), while 13 HCC nodules in a similar location were included as a control group. For the study group, the tumor and adjacent bile ducts were outlined on preprocedural MR images. Procedural ablation planning was conducted to assess the feasibility of ablating the tumors while avoiding biliary injury. Such tumors were then ablated under US-MR fusion imaging guidance. The control group nodules were ablated under conventional ultrasound guidance. Baseline characteristics and outcomes were compared between the groups.
After preprocedural assessment, 14 of 18 patients with tumors that were feasible to ablate underwent US-MR fusion imaging-assisted RFA. No biliary complications were observed in these 14 patients; the complication rate was significantly lower in the study group than in the control group (30.8%, 4/13) ( = 0.041). There was no significant difference in the technique efficacy rates [92.9% (13/14) 100% (13/13), = 1] or local progression rates [7.1% (1/14) 7.7% (1/13), = 1] between the study and control groups.
US-MR fusion imaging may be a non-invasive means for assisting RFA of HCC nodules proximal to the HBDs and ensuring ablation safety.
通过一项初步的对比研究，探讨超声（US）-磁共振（MR）融合成像能否提高肝门部胆管（HBDs）附近肝细胞癌（HCC）的消融安全性。
2014年1月至2019年6月，将18个位于HBDs附近的HCC结节纳入US-MR融合成像辅助射频消融（RFA）组（研究组），同时将13个位于相似位置的HCC结节作为对照组。对于研究组，在术前MR图像上勾勒出肿瘤及相邻胆管。进行消融手术规划，以评估在避免胆管损伤的情况下消融肿瘤的可行性。然后在US-MR融合成像引导下对这些肿瘤进行消融。对照组结节在传统超声引导下进行消融。比较两组的基线特征和结果。
经过术前评估，18例可行消融的肿瘤患者中有14例接受了US-MR融合成像辅助RFA。这14例患者均未观察到胆管并发症；研究组的并发症发生率显著低于对照组（30.8%，4/13）（P = 0.041）。研究组与对照组之间的技术有效率[92.9%（13/14）对100%（13/13），P = 1]或局部进展率[7.1%（1/14）对7.7%（1/13），P = 1]无显著差异。
US-MR融合成像可能是辅助HBDs附近HCC结节RFA并确保消融安全的一种非侵入性手段。
