Published online Sep 15, 2022. doi: 10.4251/wjgo.v14.i9.1727
Peer-review started: March 14, 2022
First decision: April 11, 2022
Revised: April 18, 2022
Accepted: July 31, 2022
Article in press: July 31, 2022
Published online: September 15, 2022
Due to the influence of the gas, the subphrenic area is one of the most difficult places for ultrasound guidance. A computed tomography (CT) scan can compensate for this shortcoming. CT-guided ablation is a commonly used ablation image-guided method in our department.
CT-guided puncture does not allow for real-time positioning and the microwave electrode needle will produce artifacts in CT scanning, which is different from our previous application of radiofrequency ablation.
To compare fine needle-assisted puncture (FNP) positioning technique and conventional puncture technique for the safety and efficacy of CT-guided microwave ablation (MWA) in treating hepatocellular carcinoma (HCC).
The efficacy and safety were compared between the patients received CT-guided MWA under FNP technique and patients received MWA under conventional puncture technique.
The 1-, 2-, and 3-year cumulative incidences of local tumor progression (LTP) in the FNP group were significantly lower than those in the conventional puncture (CP) technique (CP group). The 1-, 2-, and 3-year RFS rates in the FNP group were significantly higher than those in the CP group. The FNP technique independently predicted LTP and recurrence-free survival (RFS). The minor complications in the FNP group were lower those in the CP group.
The FNP technique used in CT-guided MWA may improve outcomes in terms of LTP, RFS, and procedure-related complications for HCC.
Prospective multicenter randomized controlled studies must be conducted in the future to obtain further insights.