3D CACT-assisted Radiofrequency Ablation Following Transarterial Chemoembolization for Hepatocellular Carcinoma: Early Experience

Background: To explored the value of 3D C-arm CT (CACT) guidance system in performing radiofrequency ablation (RFA) following transarterial chemoembolizationon (TACE) for hepatocellular carcinomas. Materials and
Methods: RFA of hepatocellular carcinomas (HCC) were performed on 15 patients (21 lesions) with the assistance of CACT guidance system. Technical success, procedure time, complications and patient radiation exposure were investigated. The puncture performance level was evaluated on a five-point scale (5-1: excellentpoor). Complete ablation rate was evaluated after two months follow-up using enhanced CT scans.
Results: The technical success rate of RFA procedure under CACT navigation system was 100 %. Mean total procedure time was 24.24 ± 6.53 min, resulting in a mean effective exposure dose of 15.4 ± 5.1 mSv. The mean puncture performance level rated for CACT guided RFA procedure was 4.87 ± 0.35. Complete ablation (CA) was achieved in 20 (95.2%) of the treated 21 tumors after the first RFA session. None of patients developed intra-procedural complications.
Conclusions: 3D CACT guidance system enables reliable and efficient needle positioning by providing real-time intraoperative guidance for performing RFA on HCCs.