Summary Background Liver resection (LRE) and microwave ablation (MWA) for hepatocellular carcinoma (HCC) have been widely compared. Aims To compare the therapeutic outcomes of percutaneous MWA and LRE for HCC in ideal candidates for ablation according to Barcelona Clinic Liver Cancer (BCLC) staging Methods Between August 2013 and November 2020, 483 consecutive patients meeting criteria for “ideal candidates for ablation” per the BCLC staging initially treated with MWA (n = 168) or LRE (n = 315) were included. Patients were further divided into BCLC‐0 (n = 116) and BCLC‐A (n = 367) groups. Overall survival (OS), recurrence‐free survival (RFS) and post‐procedure‐related complication rates were compared before and after propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) in the overall population and subgroups. Multivariate Cox regression analysis was performed to determine whether the treatment modality was an independent prognostic factor. Results LRE had a better RFS and similar OS and post‐procedure‐related complication rates compared to MWA in the overall population and in the BCLC‐A subgroup both before and after PSM and IPTW. However, the OS, RFS and post‐procedure‐related complication rates were equivalent between the two groups before and after PSM and IPTW in patients with BCLC‐0 disease. The multivariate Cox regression analysis showed that LRE was associated with better RFS over MWA in overall population (p = 0.003; HR = 0.67; 95% CI: 0.51–0.87) and BCLC‐A disease (p = 0.046; HR = 0.74; 95% CI: 0.56–0.99), while it did not differ in OS. Conclusion An ‘ideal candidate for ablation’ according to the BCLC staging system may not be an ideal candidate for MWA. However, patients with BCLC‐0 may be the optimal population for MWA.

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Objectives: To investigate the necessity of cone-beam computed tomography (CBCT) in adrenal venous sampling (AVS).Methods: This retrospective study included 120 consecutive patients with primary hyperaldosteronism who underwent AVS. Based on the learning curve of the interventional radiologists, the patients were divided into the learning (n=36) and proficiency (n=84) groups chronologically. Based on the imaging pattern of the right adrenal vein (RAV), the patients were divided into the typical (n=36) and atypical (n=84) groups. The success rate, radiation dose, and sampling time were compared among the entire study population and each subgroup.Results: A total of 69 patients underwent CBCT, whereas 51 patients did not. The overall success rate was 85.8%, and no difference was noted between patients with and without CBCT (P=0.347). However, radiation dose (P=0.018) and sampling time (P=0.001) were significantly higher in patients who underwent CBCT than in patients who did not. In learning group, CBCT improved success rate from 62.5% to 96.4% (P=0.028), whereas it was not found in the proficiency group (P=0.693). Additionally, success rate in patients with an atypical RAV imaging pattern was significantly higher when CBCT was used than when it was not used (P=0.041), whereas no difference was noted in patients with typical RAV imaging pattern (P=0.511).Conclusion: For physicians not very experienced doing AVS, there is a clear significant improvement in success rate when CBCT is used. However, CBCT only has minimal benefit for experienced operators, meanwhile CBCT may take an extra time and increase the radiation dose during AVS.

Objectives To investigate the necessity of cone-beam computed tomography (CBCT) in adrenal venous sampling (AVS). Methods This retrospective study included 120 consecutive patients with primary hyperaldosteronism who underwent AVS. Based on the learning curve of the interventional radiologists, the patients were divided into the learning (n = 36) and proficiency (n = 84) groups chronologically. Based on the imaging pattern of the right adrenal vein (RAV), the patients were divided into the typical (n = 36) and atypical (n = 84) groups. The success rate, radiation dose, and sampling time were compared among the entire study population and each subgroup. Results A total of 69 patients underwent CBCT, whereas 51 patients did not. The overall success rate was 85.8%, and no difference was noted between patients with and without CBCT (P = 0.347). However, radiation dose (P = 0.018) and sampling time (P = 0.001) were significantly higher in patients who underwent CBCT than in patients who did not. In learning group, CBCT improved success rate from 62.5 to 96.4% (P = 0.028), whereas it was not found in the proficiency group (P = 0.693). Additionally, success rate in patients with an atypical RAV imaging pattern was significantly higher when CBCT was used than when it was not used (P = 0.041), whereas no difference was noted in patients with typical RAV imaging pattern (P = 0.511). Conclusion For physicians not very experienced doing AVS, there is a clear significant improvement in success rate when CBCT is used. However, CBCT only has minimal benefit for experienced operators, meanwhile CBCT may take an extra time and increase the radiation dose during AVS.