When it comes to image-guided ablations, the most cost-effective modality is also the least effective option
When it comes to image guidance during ablative procedures, not all modalities are created equal, according to new data.
Ablation therapy is routinely used to treat hepatocellular carcinoma (HCC); it requires image guidance, which is usually done with ultrasound, CT or MRI. While ultrasound is the most easily accessible and cost-friendly option, a new paper in Clinical Radiology suggests its use may lead to poorer outcomes.
“The application of imaging guidance in ablation therapy for HCC demonstrates respective advantages and limitations,” Liang Chen, with the department of radiology, The First People's Hospital of Daishan, in China, and colleagues wrote. “Previous studies have explored the use and effectiveness of different imaging-guided techniques for HCC ablation but systematic reviews and meta-analyses on this topic are limited.”
Researchers conducted a meta-analysis on all papers relating to different image guidance methods (ultrasound, CT or MRI) during ablation for HCC to determine whether outcomes were more favorable with a specific modality. In total, 11 studies containing data from over 1,200 procedures were analyzed. Endpoints included treatment efficacy, safety, local recurrence and survival rate.
In terms of treatment efficacy, data revealed both CT and MRI were significantly more effective than ultrasound. Individuals who underwent CT or MRI had markedly lower recurrence rates, and they also benefited from fewer post-procedural adverse side effects. The authors attributed these findings to the superior positioning accuracy and real-time monitoring capabilities afforded by CT and MRI. Each offer enhanced image quality as well, the group noted.
The team's findings are in line with prior research on the topic.
“Another study compared the effectiveness of CT and MRI-guided MWA and found that MRI-guidance had certain advantages in technical success rates and complication rates,” the authors noted. “However, due to cost and technical complexity, MRI-guidance is limited in practical clinical application.”
Similarly, the group determined that CT and MRI utilization lag behind ultrasound due to the time- and cost-related factors. The group suggested that future work should focus on how to overcome these variables to provide patients with the best possible chance of favorable outcomes.
Learn more about the study here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.