Objectives: Primary objective was to report the feasibility, safety and efficacy of percutaneous ablation of hepatic malignant tumors that are undetectable or inconspicuous in non-enhanced computed tomography (CT) scans using an electromagnetic navigation system with a marker option. Secondary objectives included the evaluation of technical parameters including the accuracy of needle placement, the number of control CT acquisitions, and procedural duration.Methods: This prospective study (performed from 1 March 2022 until 30 November 2024) included all patients with hepatic tumors (not visible or poorly defined on non-enhanced CT) who underwent percutaneous microwave ablation (MWA). Technical efficacy was assessed with contrast-enhanced CT immediately post-ablation, and oncologic outcomes (overall and progression-free survival) were evaluated with MRI at 1, 3, and 6 months.Results: Fifteen patients (12 males, 3 females; mean age of 66 years) with 16 tumors (median diameter of 15 mm) were treated in 16 sessions. Tumor types included hepatocellular carcinoma (n= 7), colorectal metastasis (n= 4), ocular melanoma (n= 1), neuroendocrine tumor (n= 1), intrahepatic cholangiocarcinoma (n= 1), and breast cancer metastasis (n= 1). Median procedure time was 53 min, scans number was nine, needle length was 12 cm, and median deviation was 1 mm. No complications were reported. Primary efficacy rate was 94% (15/16), rising to a secondary (assisted) technique efficacy of 100% after re-ablation (one session). During median follow-up of 23 months, local tumor progression-free survival was 100%; distant progression-free survival was 80%, and two patients (13.3%) died, one being cancer-related.Conclusions: Electromagnetic navigation with a marker option enables safe, accurate, and effective MWA of inconspicuous hepatic tumors, achieving excellent local control with favorable oncologic outcomes.
目的：主要目的是报告使用带标记物选项的电磁导航系统，对非增强计算机断层扫描（CT）中不可见或不明显的肝脏恶性肿瘤进行经皮消融的可行性、安全性及有效性。次要目标包括评估技术参数，如针头放置的准确性、控制性CT采集次数及手术时长。 方法：这项前瞻性研究（2022年3月1日至2024年11月30日进行）纳入了所有肝脏肿瘤（在非增强CT中不可见或边界不清）并接受经皮微波消融（MWA）的患者。技术有效性通过消融后即刻的增强CT进行评估，肿瘤学结果（总生存期和无进展生存期）在术后1、3、6个月通过MRI进行评估。 结果：共15例患者（12例男性，3例女性；平均年龄66岁）的16个肿瘤（中位直径15毫米）接受了16次治疗。肿瘤类型包括肝细胞癌（n=7）、结直肠转移瘤（n=4）、眼黑色素瘤（n=1）、神经内分泌肿瘤（n=1）、肝内胆管癌（n=1）和乳腺癌转移瘤（n=1）。中位手术时间为53分钟，扫描次数为9次，针头长度为12厘米，中位偏差为1毫米。未报告并发症。初次技术有效率为94%（15/16），经再次消融（1次）后，二次（辅助）技术有效率提升至100%。在中位随访23个月期间，局部肿瘤无进展生存率为100%；远处无进展生存率为80%，2例患者（13.3%）死亡，其中1例与癌症相关。 结论：带标记物选项的电磁导航系统能够安全、准确、有效地对不明显的肝脏肿瘤进行微波消融，实现了优异的局部控制效果和良好的肿瘤学结局。
肿瘤(癌症)患者之家