Image-guided radiofrequency ablation of hepatocellular carcinoma (HCC): Is MR guidance more effective than CT guidance?

Objectives: The purpose of the study was to retrospectively compare technique effectiveness of computed tomography (CT)-guided versus magnetic resonance (MR)-guided radiofrequency (RF) ablation of hepatocellular carcinoma (HCC). Materials and methods: In 35 consecutive patients 53 CT-guided (n=29) or MR-guided (n=24) ablation procedures were performed in the treatment of 56 (CT: 29; MR: 27) HCC. The entire ablation procedure was performed at a multislice CT-scanner or an interventional 0.2-Tesla MR-scanner. Assessment of treatment response was based on dynamic MR imaging at 1.5 Tesla. The mean follow-up was 22.9 months. Primary technique effectiveness was assessed 4 months after ablation therapy. Secondary technique effectiveness was assessed 4 months after a facultative second ablation procedure. Primary and secondary technique effectiveness of CT-guided and MR-guided RF ablation was compared by using Chi-Square (likelihood ratio) test. Results: Primary technique effectiveness after a single session was achieved in 26127(96.3%) HCC after MR-guided RF ablation and 23129 (79.3%) HCC after CT-guided RF ablation (Chi-Square: p=0.04). Secondary technique effectiveness was achieved in 26127 (96.3%) HCC after MR-guided RF ablation and in 26129 (89.7%) HCC after CT-guided RF ablation (Chi-Square: p = 0.32). A local tumor progression was detected in 8152 (15.4%) tumors after initial technique effectiveness. Major complications were detected after 3153 (5.7%) ablation procedures. Conclusions: CT-guided and MR-guided RF ablations are locally effective therapies in the treatment of HCC. Due to a higher rate of primary technique effectiveness MR-guided RF ablation may reduce the number of required sessions for complete tumor treatment. (C) 2013 Elsevier Ireland Ltd. All rights reserved.