To evaluate the clinical application value of multi-modality imaging in precise resection for primary liver cancer (PLC).

Clinical data of 69 patients with PLC who underwent precise liver resection in Yuebei People's Hospital from January 2018 to January 2021 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 52 patients were male and 17 female, aged from 21 to 77 years, with a median age of 55 years. According to different digital medical imaging techniques used preoperatively, all patients were divided into the multi-modality imaging guiding group (multi-modality group, n=32) and three-dimensional (3D) visualization guiding group (single-modality group, n=37). In the multi-modality group, 3D visualization reconstruction, 3D printing and augmented reality (AR) were employed for preoperative evaluation, surgical planning and surgical navigation. In the single-modality group, 3D visualization was utilized for surgical planning before operation. Perioperative conditions and clinical prognosis were compared between two groups. The operation time and intraoperative blood loss between two groups were statistically compared by t test or rank-sum test. The rate comparison was conducted by Chi-square test.

3D visualization reconstruction models were successfully established for 69 patients. In the multi-modality group, intraoperative findings were consistent with those of 3D visualization, 3D printing and AR. Understanding on the surgical plan was highly consistent with the cooperation of the surgical team. All patients successfully completed the surgery. No perioperative death and severe postoperative complications were observed. In the multi-modality group, the average operation time and hepatic blood inflow occlusion duration were (203±59) min and(27±13) min, significantly shorter than (235±62) min and (34±13) min in the single-modality group (t=-2.193, -2.178; P<0.05). In the multi-modality group, the median intraoperative blood loss was 165(235) ml, significantly less than 200(100) ml in single-modality group (Z=-2.472, P<0.05). In the single-modality group, 4 cases developed postoperative recurrence and metastases and 3 cases in the multi-modality group. No significant difference was noted in the recurrence-free survival rate between two groups (χ²=0.032, P>0.05).

Multi-modality imaging possesses the advantage of multi-informatization and resolves the limitations of single-modality imaging. Besides, it can improve the accuracy and safety of precise resection for PLC through accurate preoperative planning and intraoperative navigation.