Combined Single-Session Stereotactic Biopsy and Microwave Ablation of Primary and Secondary Liver Tumors

Zhang, Liang and Ngu, Anthony and Kupke, Laura Sophia and Mayr, Vinzenz and Strotzer, Quirin and Brandenstein, Moritz and Stroszczynski, Christian and Einspieler, Ingo (2025) Combined Single-Session Stereotactic Biopsy and Microwave Ablation of Primary and Secondary Liver Tumors. BIOMEDICINES, 13 (12): 2865. ISSN 2227-9059

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Abstract

Objective: To evaluate the safety, diagnostic yield, and ablation efficacy of a single-session workflow combining stereotactic percutaneous core-needle biopsy (CNB) immediately followed by microwave ablation (MWA) for liver tumors. Methods: We retrospectively reviewed consecutive patients (December 2021-May 2025) who underwent stereotactic CNB followed by MWA in the same procedure. Primary endpoints were primary technique efficacy (PTE) and complications. Secondary endpoints were 6-month local tumor progression (LTP) and diagnostic yield. Six-month LTP was summarized using a Kaplan-Meier (KM) point estimate with Greenwood 95% CIs. Results: Thirty-three patients underwent single-session biopsy and ablation (33 biopsied; 41 lesions ablated). PTE was 95.1% (39/41); two residual tumors were successfully re-ablated. Six-month LTP was 3.6% (patient level; KM 95% CI 0.0-10.5%) and 2.8% (lesion level; KM 95% CI 0.0-8.2%). There was one major complication (3%, post-ablation abscess) and no minor complications. Adequate tissue was obtained in all biopsies; a definitive diagnosis was established in 88% (29/33): malignancy in 73% (24/33) and benignity in 15% (5/33); 12% (4/33) were nondiagnostic. In the hepatocellular carcinoma (HCC)-suspected subgroup (LI-RADS LR-3 to LR-5; n = 24), all LR-5 lesions were HCC (11/11). Among LR-4 lesions (n = 7), histology showed HCC in 1/7 (14%) and cholangiocarcinoma in 2/7 (29%); 4/7 (57%) were benign or nondiagnostic. Among LR-3 lesions (n = 6), 2/6 (33%) were HCC and 4/6 (67%) were benign or nondiagnostic. In the metastasis-suspected subgroup (n = 9), malignancy was confirmed in 8/9 (89%); 1/9 (11%) was nondiagnostic. Conclusions: Single-session stereotactic CNB followed by MWA is feasible and safe, yields diagnostically useful tissue, and achieves high ablation efficacy.

Item Type: Article
Uncontrolled Keywords: PERCUTANEOUS NEEDLE-BIOPSY; DIAGNOSTIC YIELD; LESIONS; RADIOFREQUENCY; METASTASES; STANDARDS; liver tumor; hepatocellular carcinoma; liver metastases; microwave ablation; tumor ablation; CT-guided ablation; stereotactic navigation; liver biopsy; single-session
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Röntgendiagnostik
Depositing User: Dr. Gernot Deinzer
Date Deposited: 23 Sep 2026 05:38
Last Modified: 23 Sep 2026 05:38
URI: https://pred.uni-regensburg.de/id/eprint/66309

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