Objective Radiofrequency ablation (RFA) is an established treatment for early-stage hepatocellular carcinoma (HCC). Imaging modalities including ultrasound (US), CT and MRI are all used to guide RFA; however, a discrepancy exists in the clinical outcomes between each modality in the literature. We evaluated the clinical outcomes of HCC patients undergoing US-guided, CT-guided and MRI-guided RFA. Methods A total of 88 consecutive patients with early-stage HCC who underwent RFA at a tertiary hepatobiliary centre were retrospectively included in this study. The primary endpoint was local recurrence-free survival (RFS), and the secondary endpoint was overall survival (OS). Univariate analyses of risk factors for RFS and OS were conducted using Cox regression models. Results There were no significant differences in RFS between the imaging modalities (US: 32.0 months, 95% CI 20.0 to 44.1 months vs CT: 20.0 months, 95% CI 6.1 to 33.9 months vs MRI: 9.0 months, 95% CI 5.6 to 12.4 months, p=0.25). Similarly, no significant differences were observed in OS (US: 85.0 months (95% CI 65.8 to 104.2 months) vs CT: 42.0 months (95% CI 31.9 to 52.1 months) vs MRI: 34.0 months (95% CI 27.1 to 52.8 months), p=0.89). The overall treatment success rate (defined as the complete ablation of the target lesion postablation on 3-month imaging) was 76.5% (69 of 88 patients), with no significant difference between the three groups (p=0.89). Conclusion US, CT and MRI-guided RFA are all effective for the treatment of HCC. Based on the findings of this study, the choice of imaging modality for ablation should consider factors such as cost, radiation exposure and accessibility.
Sahu et al. (Fri,) studied this question.