# Intra-procedural Cone-Beam Computed Tomography for Ultrasound-Guided Microwave Ablation of Hepatocellular Carcinoma: An Initial Experience

## TL;DR

This paper explores using cone-beam CT during ultrasound-guided microwave ablation for liver cancer, showing it can be safe and effective.

## Contribution

The study presents initial clinical experience of combining intra-procedural CBCT with ultrasound-guided ablation for HCC.

## Key findings

- Intra-procedural CBCT improves visualization and accuracy of thermal probe placement during ablation.
- The combined technique is safe and effective for treating hepatocellular carcinoma in the liver.
- Ultrasound-guided ablation with CBCT reduces reliance on CT scanners and procedure time.

## Abstract

Ultrasound-guided microwave ablation is an alternative to the more widespread computed tomography (CT)-guided ablation. It confers some advantages such as immediate probe position adjustments, observation of real-time effects of ablation, lower radiation dose, and reduction in procedure time without increasing demand on diagnostic CT scanners. However, opponents of this technique cite the difficulty of visualising the thermal probe position or ablation zone. Incorporating cone-beam CT (CBCT) during ultrasound-guided tumour ablation allows improved visualisation and accuracy of thermal probe placement, but little data is available on this combined approach. We describe our centre's experience of the use of intra-procedural CBCT to aid the accuracy of ultrasound-guided microwave tumour ablation of hepatocellular carcinoma (HCC) in the liver. Our results demonstrate that employing intra-procedural CBCT during ultrasound-guided ablation of HCC liver tumours can be a safe and effective minimally invasive technique.