Percutaneous Magnetic Resonance Imaging-Guided Microwave Ablation for Patients with Cirrhosis Complicated by Small Hepatocellular Carcinoma

Objective: To assess the technical effectiveness and therapeutic outcomes of percutaneous magnetic resonance (MR)-guided microwave ablation (MWA) in the treatment of patients with cirrhosis complicated by small hepatocellular carcinoma (HCC).

Materials and methods: A single center retrospective analysis of consecutive cases involving 1.5T MR-guided MWA for hepatocellular carcinoma was performed. 53 patients with cirrhosis, harboring 74 HCC lesions (mean diameter: 13.0 ± 6.0 mm, range: 6.0-29.0 mm), were included in this study. Follow-up MRI was performed postprocedurally to assess technical efficacy, while local progression-free survival and overall survival rates were calculated over the study period.

Results: MR-guided MWA was performed with technical success in all cases with no severe adverse events occurring during the single-session treatment. The mean follow-up duration was 46.1 ± 17.9 months (median: 52 months). Local tumor progression was observed in one perivascular lesion, accounting for 1.9% of the cases. The mean recurrence-free survival (RFS) was 31.1 ± 22.2 months, with a median of 24.5 months. Local progression-free survival (LPFS) rates at one, three, and five years were 98.1%. The overall survival rates at one, three, and five years were 96.2%, 84.9%, and 71.6%, respectively.

Conclusion: Percutaneous MR-guided MWA for small HCC in cirrhosis patients demonstrated high technical success, accurate evaluation of ablation margins, and minimal local tumor progression after a single treatment session, resulting in favorable therapeutic outcomes.