Perfluorobutane application value in microwave ablation of Small Hepatocellular Carcinoma (<3 cm)

Abstract

BACKGROUND: No studies have been retrieved comparing perfluorobutane with sulfur hexafluoride for microwave ablation (MWA) in small hepatocellular carcinoma(sHCC). OBJECTIVE: To retrospective investigate the value of perfluorobutane ultrasonography contrast agent in ultrasonography (US)-guided MWA of sHCC. METHODS: We conducted a retrospective clinical controlled study about US-guided percutaneous MWA in patients with sHCC, and in patients undergoing intra-operative treatment with perfluorobutane or sulfur hexafluoride. In both groups, a contrast agent was injected to clear the tumor and then a needle was inserted. A 5-point needle prick difficulty score was developed to compare needle prick difficulty in the two groups of cases. RESULTS: A total of 67 patients were included: 25 patients in group perfluorobutane, aged 41–82 (60.64±9.46), tumor size 1.1–2.8 (1.78±0.45) cm. 42 patients in group sulfur hexafluoride, aged 38–78 (62.26±9.27), with tumor size of 1.1–3.0 (1.89±0.49) cm. There was no significant difference in age or tumor size in both groups (P >  0.05). Puncture difficulty score (5-point): 2.0–2.7 (2.28±0.29) in group perfluorobutane, and 2.0–4.7 (2.95±0.85) in group sulfur hexafluoride, and the difference between the two groups was statistically significant (P <  0.05). Enhanced imaging results within 3 months after surgery: complete ablation rate was 100% (25/25) in the group perfluorobutane, 95.2% (40/42 in the group sulfur hexafluoride), with no significant difference between the two groups (P >  0.05). CONCLUSION: Perfluorobutane kupffer phase can make the operator accurately deploy the ablation needle and reduce the difficulty of operation.