Computer Guided Microwave Liver Ablation

Inclusion Criteria: 1. Age ≥ 18 years, with life expectancy of at least 1 year 2. Diagnosis of hepatocellular carcinoma (HCC) confirmed by: * LI-RADS 5 imaging features or * Histopathology * Cirrhosis with AFP \> 400 3. Localized disease without macrovascular invasion or extrahepatic metastasis, eligible for curative-intent percutaneous thermal ablation, defined as: o Up to 5 lesions with at least one lesion, 2 -5 cm, and no lesion \>5 cm diameter 4. Tumor location deemed technically feasible for percutaneous ablation by the treating interventional radiologist 5. ECOG Performance Status 0-2 6. Adequate coagulation status, defined as: * Platelets ≥ 50,000/μL * INR ≤ 1.8 (or correctable) 7. Ability to undergo contrast-enhanced CT or MRI 8. Willingness and ability to provide informed consent Exclusion Criteria: 1. Prior local therapy to the target lesion (ablation, TACE, SBRT, or resection) or to a lesion within 1 cm of the target lesion 2. More than 5 hepatic lesions, or any lesion ineligible for technically complete ablation 3. uncontrolled hepatic decompensation, including: o Persistent encephalopathy 4. Uncorrectable coagulopathy or contraindication to percutaneous liver intervention 5. Contraindication to contrast-enhanced imaging (e.g., severe CKD without dialysis, contrast allergy not correctable with premedication) 6. Active systemic infection 7. Pregnancy 8. Inability to comply with follow-up imaging schedule