Contrast-enhanced ultrasound-guided feeding artery ablation as add-on to percutaneous radiofrequency ablation for hypervascular hepatocellular carcinoma with a modified ablative technique and tumor perfusion evaluation

Autor: Xiaoju Li, Ming Xu, Ming Liu, Yang Tan, Bowen Zhuang, Manxia Lin, Ming Kuang, Xiaoyan Xie
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: International Journal of Hyperthermia, Vol 37, Iss 1, Pp 1016-1026 (2020)
Druh dokumentu: article
ISSN: 0265-6736
1464-5157
02656736
DOI: 10.1080/02656736.2020.1811902
Popis: Objectives To establish a modified strategy of the feeding artery ablation (FAA) procedure as an add-on to percutaneous radiofrequency ablation (RFA) for patients with hypervascular hepatocellular carcinoma (HCC), and to evaluate the outcomes. Materials and methods For this prospective, single-arm study, from June 2014 to August 2016, twenty-five patients with hypervascular HCC, 2–5 cm in diameter were treated by contrast-enhanced ultrasound (CEUS)-guided FAA before conventional RFA. Technical success of FAA and subsequent perfusion change of the tumor were evaluated by CEUS. Technical efficacy and ablation sizes were evaluated by CT/MRI at 1 month. Therapeutic outcomes, including local tumor progression (LTP), overall survival (OS), and recurrence-free survival (RFS) were evaluated using the Kaplan–Meier method. Results One or two target feeding arteries were visible on CEUS for 52.6% (61/116) of the hypervascular HCCs 2–5 cm in diameter. The technical success rate of the FAA was 100%; 13/25 (52.0%) target tumors were evaluated as complete perfusion response, while 12/25 (48.0%) were evaluated as partial perfusion response. The ablation volume was 41.9 ± 17.5 cm3 (14.9–78.2 cm3) and the ablative safety margin was 8.2 ± 1.9 mm (4–12 mm) at the 1-month evaluation. These parameters did not differ significantly between the complete and partial subgroups. The cumulative rates of LTP at 1-, 2-, and 3-year follow-ups were 0.0%, 4.2% and 4.2%, respectively. The 3-year OS and RFS were 70.3% vs. 59.8%, respectively. There were no treatment-related deaths. Major complications occurred in one patient (4.0%). Conclusion As an add-on to conventional percutaneous RFA, tailored CEUS-guided FAA can reduce tumor perfusion and provide good local control of HCC.
Databáze: Directory of Open Access Journals
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