Transcatheter CT Hepatic Arteriography versus Conventional CT Guidance for Percutaneous Microwave Ablation of Small Hepatocellular Carcinoma Tumors.

Purpose To evaluate the safety and efficacy of transcatheter CT hepatic arteriography (angio-CT)-guided percutaneous microwave ablation (AA) for small hepatocellular carcinoma tumors and compare its outcomes with those of conventional CT-guided microwave ablation (CA). Materials and Methods The authors performed a retrospective review of patients with hepatocellular carcinoma tumors less than 3 cm in size treated with AA and CA from June 2019 to August 2024 at a single institution. Hepatic arteriography was performed after transarterial catheterization in an angio-CT hybrid suite. CA was performed with or without US. The authors evaluated the target-lesion radiologic response according to modified Response Evaluation Criteria in Solid Tumors criteria at follow-up contrast-enhanced CT or MRI. Target-lesion progression-free survival (PFS) and overall survival were calculated using the Kaplan-Meier method. Cox regression hazard models were used to identify variables associated with PFS. Adverse events were retrospectively reviewed. Results A total of 70 patients and 85 tumors were included in this study (mean age, 63.2 years ± 9.5 [SD]; 49 male patients). Thirty-six tumors (27 patients) were treated with AA. Forty-nine tumors (43 patients) were treated with CA. The 3-month complete response rate (100% vs 79.6%;