The HepACAGA (Hepatic Arteriography and C-arm CT-Guided Ablation) technique, which integrates C-arm CT guidance with transcatheter C-arm CT hepatic arteriography (C-arm CTHA), significantly improves liver tumor ablation outcomes by enhancing tumor visualization, navigation, and the intraprocedural assessment of ablation margins. The two key advantages of using C-arm CT over conventional CT for image guidance are firstly that the entire procedure can be performed in the angiography suite, eliminating the need for patient transfer between the angiography suite (catheterization) and CT-room (ablation), and secondly, that integrated C-arm needle guidance software can greatly reduce the difficulty of needle placement. Beyond these advantages, the HepACAGA technique offers additional benefits across four domains: (1) the direct conversion of ablation to intra-arterial liver-directed therapies (e.g., radioembolization or chemoembolization) upon the intraprocedural detection of disease progression; (2) the direct combination of ablation with intra-arterial treatments or portal vein embolization in one session; (3) the enhanced ablation effect through heat sink effect reduction with adjunct bland embolization or balloon occlusion; and (4) the immediate hemorrhage control through direct embolization. This pictorial essay demonstrates the advantages of combining C-arm CT guidance with real-time C-arm CTHA in the percutaneous thermal ablation of liver tumors, with clinical cases illustrating each of the aforementioned four key domains.
HepACAGA（肝动脉造影与C臂CT引导消融）技术通过整合C臂CT引导与经导管C臂CT肝动脉造影，显著提升肝脏肿瘤消融疗效。该技术通过增强肿瘤可视化、导航能力及术中消融边界评估，优化了治疗流程。相较于传统CT影像引导，C臂CT的两大核心优势在于：其一，整个手术可在血管造影室完成，避免了患者在血管造影室（导管置入）与CT室（消融治疗）之间的转运需求；其二，集成的C臂穿刺针引导软件能大幅降低穿刺置针难度。除上述优势外，HepACAGA技术还在四个领域展现出附加价值：（1）术中检测到疾病进展时，可直接将消融转为动脉内肝脏导向治疗（如放射栓塞或化疗栓塞）；（2）可在单次治疗中直接联合消融与动脉内治疗或门静脉栓塞；（3）通过辅助性空白栓塞或球囊封堵减少热沉效应，从而增强消融效果；（4）通过直接栓塞实现即时出血控制。本影像学专题通过临床案例分别阐述上述四个关键领域，展示C臂CT引导联合实时C臂CT肝动脉造影在经皮肝脏肿瘤热消融中的综合优势。
肿瘤(癌症)患者之家