To evaluate the clinical value of multi-image fusion ultrasound-guided laser ablation (LA) in the treatment of liver cancer at special sites.

28 patients with liver cancer at special sites who received multi-image fusion ultrasound-guided LA in the First People's Hospital of Yunnan Province from December 2019 to December 2021 were enrolled. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 25 patients were male and3 female, aged from 39 to 68 years, with a median age of 55 years. All patients were diagnosed with a single lesion, 0.5-1.9 cm in diameter. The lesions were located adjacent to the bile duct or portal vein in 13 cases, adjacent to the gallbladder in 8 and adjacent to the hepatic vein in 7, respectively. Before surgery, three-dimensional reconstruction technology was adopted for surgical plan. Intraoperatively, multi-image fusion ultrasound-guided precision LA was performed. Clinical efficacy of LA was observed. Clinical efficacy and quality of life were evaluated during 6-month follow-up.

All patients completed multi-image fusion ultrasound-guided LA. No perioperative complications or death occurred. All patient recovered well and were discharged. Postoperative AFP level was decreased in 25 cases, not significantly changed in 2, and increased in 1. Enhanced CT scan at postoperative 6 months showed that 26 of 28 tumors were completely ablated, and the complete remission rate was 92.8%(26/28). After surgery, the diameter of one tumor was reduced by more than 60% compared with preoperative data, and the partial remission rate was 3.6%(1/28). The tumor diameter was not significantly decreased in 1 patient, new lesions were observed surrounding the lesion, and the disease-progression rate was 3.6%(1/28). The grade of life quality score at postoperative 6 months was good in 75%(21/28) of patients, moderate in 14%(4/28) and average in 11%(3/28).

Multi-image fusion ultrasound-guided LA can make the ablation of complex and high-risk liver cancer at special sites more accurate, simpler and safer, improve the precision of surgery, reduce the risk of surgery, thus to realize precise treatment.