Evaluation of hepatocellular carcinoma ablative margins using fused pre- and post-ablation hepatobiliary phase images.
Abdom Radiol (NY)
; 44(3): 923-935, 2019 03.
Article
em En
| MEDLINE
| ID: mdl-30327828
ABSTRACT
PURPOSE:
To retrospectively evaluate the utility of fusion images of pre- and post-ablation hepatobiliary phase (HBP) series to assess the ablation margins after radiofrequency ablation (RFA) of hepatocellular carcinomas (HCCs). Additionally, to identify factors indicative of an adequate ablation margin and predictors of local tumor progression (LTP).METHODS:
Fifty-nine HCCs in 29 patients were treated by RFA and followed-up for > 1 year (mean 37.9 months). Fusion images of pre- and post-ablation HBP series were created using a non-rigid registration and manual correlation. The ablation margin appearance was classified as ablation margin + (ablation margin completely surrounding the tumor), ablation margin-zero (a partially discontinuous ablation margin without protrusion of HCC), ablation margin-(a partially discontinuous ablation margin with protrusion of HCC), and indeterminate (index tumor was not visible). The minimal ablation margin was measured, and clinical factors were examined to identify other risk factors for LTP.RESULTS:
LTP was observed at follow-up in 12 tumors. The mean minimal ablation margin was 3.6 mm. Multivariate analysis revealed that the ablation margin status was the only significant factor (p = 0.028). The cumulative LTP rates (3.3%, 3.3%, and 3.3% at 1, 2, and 3 years, respectively) in 30 ablation margin + nodules were significantly lower (p = 0.006) than those (20.0%, 28.0%, and 32.2% at 1, 2, and 3 years, respectively) in 25 ablation margin-zero nodules.CONCLUSIONS:
Fusion images enable an early assessment of the ablation efficacy in the majority of HCCs. The ablation margin status is a significant factor for LTP.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Interpretação de Imagem Assistida por Computador
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Ablação por Cateter
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Carcinoma Hepatocelular
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Margens de Excisão
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Neoplasias Hepáticas
Tipo de estudo:
Guideline
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article