Evaluation of the efficacy of CT/MR-Ultrasound Fusion Imaging in Ablation of Hepatocellular Carcinoma

Abstract Objective To investigate the efficacy and safety of intraoperative CT/magnetic resonance-ultrasound (CT/MR-US) fusion imaging in thermal ablation therapy for hepatocellular carcinoma (HCC). Methods A total of 281 HCC patients (231 males and 50 females, median age 58 years) meeting the Milan criteria were retrospectively enrolled from January 2023 to December 2024. All patients underwent percutaneous thermal ablation guided by intraoperative CT/MR-US fusion imaging. Technical efficacy and major complications were calculated. Overall survival (OS), cumulative local tumor progression (LTP), and tumor-free survival(TFS) were estimated using the Kaplan-Meier method. Results Among 463 nodules in 281 patients, all procedures were successfully completed. The technical and clinical success rates were both 100% (463/463). The postoperative complication rate was 3.6% (10/281). During a median follow-up of 5.97 months, the OS rate was 99.6%, with an LTP rate of 0.86% (4/463) and an intrahepatic recurrence rate of 16.01% (45/281). The median TFS was 19.87 months. Conclusion CT/MR-US fusion imaging is an effective technique for HCC thermal ablation, demonstrating high success rates, low complications, and favorable short-term outcomes. It is particularly applicable for HCC patients meeting the Milan criteria. Further validation is required for its long-term efficacy and applicability in advanced-stage HCC.