Intra-procedural Cone-Beam Computed Tomography for Ultrasound-Guided Microwave Ablation of Hepatocellular Carcinoma:...

Ultrasound-guided microwave ablation is an alternative to the more widespread computed tomography (CT)-guided ablation. It confers some advantages such as immediate probe position adjustments, observation of real-time effects of ablation, lower radiation dose, and reduction in procedure time without increasing demand on diagnostic CT scanners. However, opponents of this technique cite the difficulty of visualising the thermal probe position or ablation zone. Incorporating cone-beam CT (CBCT) during ultrasound-guided tumour ablation allows improved visualisation and accuracy of thermal probe placement, but little data is available on this combined approach. We describe our centre's experience of the use of intra-procedural CBCT to aid the accuracy of ultrasound-guided microwave tumour ablation of hepatocellular carcinoma (HCC) in the liver. Our results demonstrate that employing intra-procedural CBCT during ultrasound-guided ablation of HCC liver tumours can be a safe and effective minimally invasive technique.