Volumetric assessment of the periablational safety margin after thermal ablation of colorectal liver metastases.
Eur Radiol
; 31(9): 6489-6499, 2021 Sep.
Article
em En
| MEDLINE
| ID: mdl-33447860
ABSTRACT
OBJECTIVES:
To retrospectively assess the periablational 3D safety margin in patients with colorectal liver metastases (CRLM) referred for stereotactic radiofrequency ablation (RFA) and to evaluate its influence on local treatment success.METHODS:
Forty-five patients (31 males; mean age 64.5 [range 31-87 years]) with 76 CRLM were treated with stereotactic RFA and retrospectively analyzed. Image fusion of pre- and post-interventional contrast-enhanced CT scans using a non-rigid registration software enabled a retrospective assessment of the percentage of predetermined periablational 3D safety margin and CRLM successfully ablated. Periablational safety zones (1-10 mm) and percentage of periablational zone ablated were calculated, analyzed, and compared with subsequent tumor growth to determine an optimal safety margin predictive of local treatment success.RESULTS:
Mean overall follow-up was 36.1 ± 18.5 months. Nine of 76 CRLMs (11.8%) developed local tumor progression (LTP) with mean time to LTP of 18.3 ± 11.9 months. Overall 1-, 2-, and 3-year cumulative LTP-free survival rates were 98.7%, 90.6%, and 88.6%, respectively. The periablational safety margin assessment proved to be the only independent predictor (p < 0.001) of LTP for all calculated safety margins. The smallest safety margin 100% ablated displaying no LTP was 3 mm, and at least 90% of a 6-mm circumscribed 3D safety margin was required to achieve complete ablation.CONCLUSIONS:
Volumetric assessment of the periablational safety margin can be used as an intraprocedural tool to evaluate local treatment success in patients with CRLM referred to stereotactic RFA. Ablations achieving 100% 3D safety margin of 3 mm and at least 90% 3D safety margin of 6 mm can predict treatment success. KEY POINTS ⢠Volumetric assessment of the periablational safety margin can be used as an intraprocedural tool to evaluate local treatment success following thermal ablation of colorectal liver metastases. ⢠Ablations with 100% 3D periablational safety margin of 3 mm and ablations with at least 90% 3D safety margin of 6 mm can be considered indications of treatment success. ⢠Image fusion of pre- and post-interventional CT scans with the software used in this study is feasible and could represent a useful tool in daily clinical practice.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Colorretais
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Ablação por Cateter
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Ablação por Radiofrequência
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Neoplasias Hepáticas
Tipo de estudo:
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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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Eur Radiol
Assunto da revista:
RADIOLOGIA
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Áustria