Real-time arteriography-directed percutaneous microwave ablation for small or poorly characterized hepatic lesions using hybrid Angio–CT

摘要

Abstract Purpose To report the utility of real-time arteriography-directed percutaneous MWA (rad-pMWA) in a hybrid angiography–computed tomography (Angio–CT) suite to treat small or inconspicuous hepatic tumors on non-contrast CT.Method This single-center retrospective cohort included 15 consecutive patients who underwent rad-pMWA (6 HCC, 4 mCRC, 4 NET, and 1 cholangiocarcinoma). The median longest axial diameter of treated tumors was 1.7 (range: 1.4–6.0) cm. Technical success, contrast use, procedure-related complication, and initial treatment response were recorded.Results Technical success was achieved in 15/15 (100) as shown by no residual enhancement on catheter-directed CT-angiography at the conclusion of the procedure. Average contrast volume use was 63.1 (SD: 29.1) ml. No major arterial access-related complication or residual tumor was noted. Complete ablation rate was 14/14 (100) at initial 6–8-week follow-up. Local disease progression occurred in one patient during follow-up.Conclusion Rad-pMWA using Angio–CT is safe and effective for improving tumor visibility and operator convenience. Tumors can be localized with low contrast dosage and ablated with high efficacy with immediate real-time evaluation of the ablation cavity.