Feasibility and safety study of ultrasound-guided percutaneous microwave ablation for sub-cardiac liver cancers without artificial ascites assistance

Br J Radiol. 2024 Nov 1;97(1163):1856-1862. doi: 10.1093/bjr/tqae169.

Abstract

Objectives: To investigate the efficacy and safety of ultrasound (US)-guided microwave ablation (MWA) without artificial ascites (AA) inpatients with sub-cardiac (SC) liver cancers.

Methods: This retrospective study included patients with the left lobe and caudate lobe of the liver cancer who underwent US-guided MWA in our institute from January 2020 to December 2022. According to whether the target lesion was located ≤5 mm from the pericardium, patients were divided into the SC group and the non-sub-cardiac (NSC) group. In the SC group, AA was not employed during the ablation procedure. The results of technical success, technical efficiency, local tumour progression (LTP), and major complications were recorded.

Results: A total of 79 patients with 87 lesions were enrolled. There were 38 patients with 38 lesions in the SC group and 41 patients with 49 lesions in the NSC group. The median follow-up of all patients was 15 (range, 3-44) months. There was no significant difference in technical success rates (100% vs 100%), technique efficiency rates (100% vs 95.7%), LTP rates (2.63% vs 0%,), and major complication rates (2.63% vs 7.32%) between the SC group and the NSC group (P > .05). No cardiac-related complications occurred.

Conclusions: US-guided MWA without AA for SC liver cancers was safe and effective.

Advances in knowledge: The clinical prognosis of thermal ablation without AA in the treatment of SC liver cancers is still unclear. The finding of this study provided evidence supporting the efficacy and safety of US-guided MWA without AA for treating this tricky location.

Keywords: artificial ascites; cardiac-related complications; microwave ablation; sub-cardiac liver cancers; ultrasound.

MeSH terms

  • Adult
  • Aged
  • Ascites / etiology
  • Carcinoma, Hepatocellular / diagnostic imaging
  • Carcinoma, Hepatocellular / surgery
  • Feasibility Studies*
  • Female
  • Humans
  • Liver Neoplasms* / diagnostic imaging
  • Liver Neoplasms* / surgery
  • Male
  • Microwaves* / therapeutic use
  • Middle Aged
  • Radiofrequency Ablation / methods
  • Retrospective Studies
  • Treatment Outcome
  • Ultrasonography, Interventional* / methods