Intratumoral perfusion may affect microwave ablation area of hepatocellular carcinoma

Abstract

Objectives

We aimed to evaluate the effect of intratumoral perfusion on microwave ablation (MWA) area in hepatocellular carcinoma (HCC).

Methods

Patients who underwent curative MWA for HCC between October 2013 and May 2015 were enrolled. Three days before MWA, contrast-enhanced ultrasound (CEUS) was performed to illustrate the perfusion characteristics of the target lesion. Using the Sonoliver quantification software, time-intensity curves of dynamic CEUS were obtained, and quantitative parameters were extracted. Two microwave antennae were inserted into the center of the tumor and MWA was performed with a continuous power output of 50 W for 5 min. A second CEUS was performed to measure the size of the ablated region. Thereafter, an additional MWA procedure was performed until complete ablation with a 5–10-mm safety margin was achieved.

Results

A total of 38 patients who underwent curative MWA for 39 HCC nodules were enrolled. The mean age was 57 years (34–80 years), and the median maximum diameter of the HCC was 3.4 cm (interquartile range, 2–6.8 cm). Time-intensity curves were obtained and the area under the curve (AUC) was selected as a parameter for intratumoral perfusion. The AUC was inversely and linearly correlated with the size of the MWA area, including long- and short-axis diameters and ablation volume. A 1,000-dB·s change in the AUC produced an average change of 1.17 ± 0.44 mm, 0.725 ± 0.355 mm, and 2.4995 ± 0.6575 cm³ in the long- and short-axis diameters and ablation volume, respectively.

Conclusions

The intratumoral perfusion of HCC was inversely correlated with MWA area size.

Keywords:

• Microwave ablation
• hepatocellular carcinoma
• contrast-enhanced ultrasound
• intratumoral perfusion
• ablation size

Acknowledgments

The authors would like to thank the participants and staff of the Department of Interventional Ultrasound, Chinese PLA General Hospital, for their valuable contributions.

Author contributions

F.B.Z. and X.L.Y. contributed to the conception of the study; F.B.Z. contributed to manuscript writing, data collection, and statistical analysis; Y.S. and Y.X.H. contributed to data collection and statistical analysis; X.L.Y. and F.Y.L. helped revise the manuscript with constructive discussions.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Additional information

Funding

This study was funded by Beijing Hospitals Authority Youth Programme (code: QML20230814) and the State Key Project on Infectious Diseases of China (Grant No. 2018ZX10723204).