Complication Rates and Risk of Recurrence After Percutaneous Radiofrequency Ablation and Microwave Ablation for the Treatment of Liver Tumors: a Meta-analysis

Comparing the efficacy and safety of cryoablation and microwave ablation in treating paravertebral metastases of rabbit VX2 tumor

We sought to assess and compare the effectiveness and safety of cryoablation (CA) and microwave ablation (MWA) in treating paravertebral metastases of VX2 in rabbits. A rabbit VX2 paravertebral metastases model was established under computed tomography (CT) guidance, with a modeling success rate of 88.23% (60/68). Sixty successfully modeled rabbits were randomly allocated into the MWA group (n = 30) and CA group (n = 30). A comparative analysis between the CA and MWA groups included assessments of the complete ablation rate, operation time, post-ablation pain, and complication rate. The complete ablation rate in the CA group (86.67%) was higher than that in the MWA group (63.33%) (P < 0.05), and the operation time in the CA group was notably longer than that in the MWA group (P < 0.05). The BRPS ( Bristol Rabbit Pain Scale)scores in both groups decreased at 5 time points after treatment, the post-treatment points scores in the CA group were lower than those in the MWA group (P < 0.001). At a follow-up of 21 days postoperatively, the complication rate in the CA group (10.00%) was significantly lower than that in the MWA group (33.33%) (P < 0.05), with 6 rabbits in the MWA group experiencing severe complications. Compared to MWA, CA for paravertebral metastases demonstrates higher efficacy and safety.

Nomogram to Predict Tumor Remnant of Small Hepatocellular Carcinoma after Microwave Ablation

RATIONALE AND OBJECTIVES

This investigation sought to create a nomogram to predict the ablation effect after microwave ablation in patients with hepatocellular carcinoma, which can guide the selection of microwave ablation for small hepatocellular carcinomas.

METHODS

In this two-center retrospective study, 233 patients with hepatocellular carcinoma treated with microwave ablation (MWA) between January 2016 and December 2023 were enrolled and analyzed for their clinical baseline data, laboratory parameters, and MR imaging characteristics. Logistic regression analysis was used to screen the features, and clinical and imaging feature models were developed separately. Finally, a nomogram was established. All models were evaluated using the area under the curve (AUC), accuracy, sensitivity, specificity, and decision curve analysis (DCA).

RESULTS

Two models and a nomogram were developed to predict ablation outcomes after MWA based on a training set (n = 182, including complete ablation: 136, incomplete ablation: 46) and an external validation set (n = 51, complete ablation: 36, incomplete ablation: 15). The clinical models and nomogram performed well in the external validation cohort. The AUC of the nomogram was 0.966 (95% CI: 0.944- 0.989), with a sensitivity of 0.935, a specificity of 0.882, and an accuracy of 0.896.

CONCLUSIONS

Combining clinical data and imaging features, a nomogram was constructed that could effectively predict the postoperative ablation outcome in hepatocellular carcinoma patients undergoing MWA, which could help clinicians provide treatment options for hepatocellular carcinoma patients.

Comparison of CT-Guided Microwave Ablation of Liver Malignancies with and Without Intra-Arterial Catheter Placement for Contrast Administration

BACKGROUND

The aim of this study was to compare microwave ablation (MWA) with and without prior placement of an intra-arterial catheter for the purpose of application of contrast medium (CM).

METHODS

148 patients (45 female, 65.1 ± 14.9 years) with liver tumors who underwent CT-guided MWA were included. Of these, 25 patients had an IA catheter placed in the hepatic artery.

RESULTS

37 patients underwent planning imaging for MWA without CM. A total of 86 patients received a standard dose of 80 mL intravenous (IV) CM for the planning scans. The patients with an IA catheter (n = 25) received an IA application of 10 mL CM. A total of 29 patients received contrast-enhanced scans in the PV phase for control of needle positioning after IV application of a standard dose of 80 mL CM. In patients with an IA catheter, control of the needle position was performed by single-slice scans. IA CM application during the ablation enabled monitoring of the ablation zone. Over the entire intervention, patients with IA catheters received less CM as compared to patients without an IA catheter (39.1 ± 10.4 mL vs. 141 ± 39.69 mL; p < 0.001).

CONCLUSIONS

IA catheter placement was associated with a significant decrease of the amount of CM during MWA and enabled monitoring of the ablation zone.

Delta-radiomics Analysis Based on Multi-phase Contrast-enhanced MRI to Predict Early Recurrence in Hepatocellular Carcinoma After Percutaneous Thermal Ablation

RATIONALE AND OBJECTIVES

It is critical to predict early recurrence (ER) after percutaneous thermal ablation (PTA) for hepatocellular carcinoma (HCC). We aimed to develop and validate a delta-radiomics nomogram based on multi-phase contrast-enhanced magnetic resonance imaging (MRI) to preoperatively predict ER of HCC after PTA.

MATERIALS AND METHODS

We retrospectively enrolled 164 patients with HCC and divided them into training, temporal validation, and other-scanner validation cohorts (n = 110, 29, and 25, respectively). The volumes of interest of the intratumoral and/or peritumoral regions were delineated on preoperative multi-phase MR images. Original radiomics features were extracted from each phase, and delta-radiomics features were calculated. Logistic regression was used to train the corresponding radiomics models. The clinical and radiological characteristics were evaluated and combined to establish a clinical-radiological model. A fusion model comprising the best radiomics scores and clinical-radiological risk factors was constructed and presented as a nomogram. The performance of each model was evaluated and recurrence-free survival (RFS) was assessed.

RESULTS

Child-Pugh grade B, high-risk tumor location, and an incomplete/absent tumor capsule were independent predictors of ER. The optimal radiomics model comprised 12 delta-radiomics features with areas under the curve (AUCs) of 0.834, 0.795, and 0.769 in the training, temporal validation, and other-scanner validation cohorts, respectively. The nomogram showed the best predictive performance with AUCs as 0.893, 0.854, and 0.827 in the three datasets. There was a statistically significant difference in RFS between the risk groups calculated using the delta-radiomics model and nomogram.

CONCLUSIONS

The nomogram combined with the delta-radiomic score and clinical-radiological risk factors could non-invasively predict ER of HCC after PTA.