Biondetti Pierpaolo, Cicchetti Francesco, Amato Gaetano Valerio Davide, Ascenti Velio, Finardi Niccolò, Tintori Jacopo, Iovino Francesco Ugo, Lanza Carolina, Angileri Salvatore Alessio, Torcia Pierluca, Ierardi Anna Maria, Vignati Giacomo, Monfardini Lorenzo Giovanni, Carrafiello Gianpaolo
Department of Diagnostic and Interventional Radiology, Foundation IRCCS Cà Granda-Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, Italy.
Postgraduate School in Radiodiagnostics, Università degli Studi di Milano, 20122 Milan, Italy.
Diagnostics (Basel). 2025 Jun 20;15(13):1573. doi: 10.3390/diagnostics15131573.
Hepatocellular carcinoma (HCC) is a major cause of cancer-related death worldwide. Percutaneous thermal ablation is an effective treatment, but standard ultrasound (US) guidance is limited in cases of inconspicuous nodules. Ultrasound fusion imaging (USFI), which overlays cross-sectional imaging onto real-time US is an emerging technique that improves tumor visibility and technical feasibility. This study reports real-life outcomes of USFI-guided microwave ablation (MWA) for HCC in two Italian centers. In this multicentric retrospective study, 56 patients with 73 poorly or non-visible HCC nodules underwent USFI-guided percutaneous MWA with no visibility or poor visibility on B-mode US. Technical success, complications, and local tumor control were evaluated, with follow-up imaging at 1 month and every 3 months thereafter. Complete response (CR) at 1 month was observed in 78.1% of nodules, with residual disease (RD) more common in poorly visible nodules than non-visible nodules (18.1% vs. 4.2%, = 0.019). During a median 13-month follow-up, local tumor progression (LTP) occurred in 9.6% of patients. No significant association was found with difficult tumor location. USFI-guided MWA is a safe and effective option for treating HCC nodules not adequately visualized with conventional US, expanding eligibility to complex cases.
肝细胞癌（HCC）是全球癌症相关死亡的主要原因。经皮热消融是一种有效的治疗方法，但在结节不明显的情况下，标准超声（US）引导存在局限性。超声融合成像（USFI）将断层成像叠加到实时超声上，是一种新兴技术，可提高肿瘤的可视性和技术可行性。本研究报告了意大利两个中心USFI引导下微波消融（MWA）治疗HCC的实际疗效。在这项多中心回顾性研究中，56例患者的73个HCC结节在B超下不可见或可见性差，接受了USFI引导下的经皮MWA治疗。评估了技术成功率、并发症和局部肿瘤控制情况，并在术后1个月及此后每3个月进行随访成像。1个月时，78.1%的结节观察到完全缓解（CR），可见性差的结节比不可见结节更常见残留病灶（RD）（18.1%对4.2%，P = 0.019）。在中位13个月的随访期间，9.6%的患者发生局部肿瘤进展（LTP）。未发现与肿瘤位置困难有显著关联。USFI引导下的MWA是治疗传统超声无法充分显示的HCC结节的安全有效选择，扩大了复杂病例的适用范围。
