title: Comparable Outcomes of Ultrasound versus Computed Tomography in the Guidance of Radiofrequency Ablation for Hepatocellular Carcinoma.
abstract: OBJECTIVE
  To compare the efficacy and safety of ultrasound (US) and computed tomography (CT) in the guidance of radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC).
  
  
  METHODS
  We retrospectively analyzed consecutive treatment-naïve patients who received curative RFA for HCC from January 2008 to July 2013. Patients were divided into the US group or the CT group according to their RFA guidance instruments. Patients who were only suitable for US- or CT-guided RFA were excluded. Cumulative incidences of and hazard ratios for HCC recurrence were analyzed after adjusting for competing mortality risk.
  
  
  RESULTS
  We recruited a total of 101 patients in the US group and 51 patients in the CT group. The baseline demographic characteristics were not significantly different in both groups. Initial response rates were similar between the two groups (US vs. CT: 89.1% vs. 92.2%, p = 0.54), and complete tumor ablation was finally achieved for all patients. However, more ablations per session were performed in US group (median 2.0 [1.0-3.0] vs. 1.0 [1.0-2.0]; p<0.01). The 1-, 2- and 3-year local tumor recurrence rates (US vs. CT: 13.0%, 20.9%, and 29.2% vs. 11.2%, 29.8% and 29.8%, respectively) and overall mortality rates (US vs. CT: 5.2%, 9.6% and 16.5% vs. 0%, 3.1% and 23.8%, respectively) were not significantly different. In multivariate analysis, tumor characteristics and underlying liver function, but not US or CT guidance, were independent prognostic factors. The complication rates were similar between the two groups (US vs. CT: 10.9% vs. 9.8%; p = 0.71), and there was no procedure-related mortality.
  
  
  CONCLUSIONS
  With comparable major outcomes, either US or CT can be used in the guidance of RFA in experience hands.
authors.affiliation: Division of Gastroenterology & Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Lu-Hung
authors.initials: LH
authors.lastname: Lee
authors.affiliation: Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan.|Department of Life Sciences, National Chung-Hsing University, Taichung, Taiwan.
authors.forename: Jen-I
authors.initials: JI
authors.lastname: Hwang
authors.affiliation: Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Yu-Chi
authors.initials: YC
authors.lastname: Cheng
authors.affiliation: Division of Gastroenterology & Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.|Department of Life Sciences, National Chung-Hsing University, Taichung, Taiwan.
authors.forename: Chun-Ying
authors.initials: CY
authors.lastname: Wu
authors.affiliation: Division of Gastroenterology & Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.|Department of Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Shou-Wu
authors.initials: SW
authors.lastname: Lee
authors.affiliation: Division of Gastroenterology & Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.|Department of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan.
authors.forename: Sheng-Shun
authors.initials: SS
authors.lastname: Yang
authors.affiliation: Division of Gastroenterology & Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Hong-Zen
authors.initials: HZ
authors.lastname: Yeh
authors.affiliation: Division of Gastroenterology & Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Chi-Sen
authors.initials: CS
authors.lastname: Chang
authors.affiliation: Division of Gastroenterology & Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.|Department of Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Teng-Yu
authors.initials: TY
authors.lastname: Lee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation; D018450:Disease Progression; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014463:Ultrasonography / Q000379:methods