Abstract: Objective To evaluate the value of real-time ultrasound guided fusion and virtual CT guided radiofrequency ablation （RFA） in the treatment of primary liver cancer in high-risk sites. Methods Clinical data of 80 patients with high-risk primary liver cancer who were treated in the First Affiliated Hospital of Guangxi Medical University from January 2017 to June 2018 were collected prospectively and divided into real-time ultrasound guided fusion virtual CT navigation radiofrequency ablation treatment group （observation group，n=42） and ultrasound guided treatment group（control group，n=38）. The localization rate，ablation rate，compli-cations，and recurrence rate were compared between the two groups. Results The initial success rate and the two ablation rates of the observation group were higher than those of the control group （P<0.05），but the recurrence rate was lower than that of the control group（2.38% vs 21.05%，P=0.011）. There was no significant difference in the incidence of complications between the two groups（2.38% vs 5.26%，P=0.602）. Conclusion High-risk primary liver cancer ultrasound guided fusion virtual CT navigation radiofrequency ablation is better than ultrasound guided therapy.

Key words: Primary liver cancer, Ultrasound guided, CT navigation, High-risk sites