Therapeutic efficacy of radiofrequency ablation in hepatocellular carcinoma evaluated with MRI and serum alpha-fetoprotein

Abstract

Objective: To investigate the feasibility of combined magnetic resonance imaging and serum alpha-fetoprotein for evaluating the therapeutic efficacy of radiofrequency ablation in patients with hepatocellular carcinoma.

Methods: The retrospective cohort study was conducted at Affiliated Hospital of North Sichuan Medical College, Sichuan, China and comprised patients with pathologically confirmed hepatocellular carcinoma lesions who underwent percutaneous radiofrequency ablation between January 1, 2018, and October 31, 2023. Magnetic resonance imaging scans were performed at baseline and seven days after radiofrequency ablation, and the subsequent follow-up magnetic resonance imaging was regularly carried out in line with the Expert Consensus on the Standardised Clinical Application of Image Guided Hepatic Tumour Thermal Ablation. Clinical data, including serum alpha-fetoprotein level, was collected at the same time points as magnetic resonance imaging. Sensitivity, specificity and accuracy were calculated to evaluate the therapeutic efficacy. Data was analysed using SPSS 22.

Results: Of the 83 patients with mean age 54.78±11.43 years, 62(74.7%) were male and 21(25.3%) were female. There were 96 lesions, and 72(75%) of them had maximum diameter <3cm, while 24(25%) had maximum diameter ranging from 3cm to 4.95cm. The mean maximum diameter of the lesions was 3.16±0.92cm, while the volume ranged from 0.15cm³ to 78.15cm³. Serum alpha-fetoprotein levels decreased significantly after radiofrequency ablation (p<0.05). The sensitivity, specificity, and accuracy of magnetic resonance imaging in the assessment of therapeutic efficacy were 90.32%, 92.31% and 91.67% for complete ablation; 83.33%, 92.31% and 90.63% for tumour residual; 89.47%, 94.37% and 93.33% for local tumour progression; and 93.55%, 95.24% and 94.68% for new tumours, respectively.

Conclusion: The combination of magnetic resonance imaging and serum alpha-fetoprotein was found to be a reliable and practical tool for evaluating the therapeutic efficacy of percutaneous radiofrequency ablation in hepatocellular carcinoma patients.

Key Words: Hepatocellular carcinoma, Radiofrequency ablation, Magnetic resonance imaging, Serum alpha-fetoprotein, Therapeutic efficacy.