Three-dimensional ultrasound fusion imaging in precise needle placement for thermal ablation of hepatocellular carcinoma

• Published in: International journal of hyperthermia 2024, Vol.41 (1), p.2316097-2316097
• Main Authors: Liu, Jiaming, Guo, Yuqing, Sun, Yueting, Liu, Ming, Zhang, Xiaoer, Zheng, Ruiying, Cong, Longfei, Liu, Baoxian, Xie, Xiaoyan, Huang, Guangliang
• Format: Article
• Language: English
• Subjects: ablation techniques; fusion image; Hepatocellular carcinoma; ultrasonography
• ISSN: 0265-6736; 1464-5157
• DOI: 10.1080/02656736.2024.2316097

To investigate the value of three-dimensional ultrasound fusion imaging (3DUS FI) technique for guiding needle placement in hepatocellular carcinoma (HCC) thermal ablation. A total of 57 patients with 60 HCCs with 3DUS FI-guided thermal ablation were retrospectively included in the study. 3DUS volume data of liver were acquired preoperatively by freehand scanning with the tumor and predetermined 5 mm ablative margin automatically segmented. Plan of needle placement was made through a predetermined simulated ablation zone to ensure a 5 mm ablative margin with the coverage rate toward tumor and ablative margin. With real-time ultrasound and 3DUS fusion imaging, ablation needles were placed according to the plan. After ablation, the ablative margin was immediately evaluated by contrast-enhanced ultrasound and 3DUS fusion imaging. The rate of adequate ablative margin, complete response (CR), local tumor progression (LTP), disease-free survival (DFS), and overall survival (OS) was evaluated. According to postoperative contrast-enhanced CT or MR imaging, the complete response rate was 100% (60/60), and 83% of tumors (30/36) achieved adequate ablative margin (>5 mm) three-dimensionally. During the follow-up period of 6.0-42.6 months, LTP occurred in 5 lesions, with 1- and 2-year LTP rates being 7.0% and 9.4%. The 1- and 2-year DFS rates were 76.1% and 65.6%, and 1- and 2-year OS rates were 98.1% and 94.0%. No major complications or ablation-related deaths were observed in any patients. Three-dimensional ultrasound fusion imaging technique may improve the needle placement of thermal ablation for HCC and reduce the rate of LTP.