Evaluation of hepatocellular carcinoma ablative margins using fused pre- and post-ablation hepatobiliary phase images

Takeyama, Nobuyuki; Mizobuchi, Naruki; Sakaki, Masashi; Shimozuma, Yu; Munechika, Jiro; Kajiwara, Atsushi; Uchikoshi, Manabu; Uozumi, Syojiro; Ohgiya, Yoshimitsu; Gokan, Takehiko

doi:10.1007/s00261-018-1800-0

Cited by 12 publications

(14 citation statements)

References 31 publications

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“…Further, similar studies are thus needed in a prospective study. Third, 3D-VIBE images had lower spatial resolution compared with previous reports [17][18][19][20][21][22][23][24][25] . Spatial resolution should be improved using thin section thickness in future work.…”

Section: Discussionmentioning

confidence: 77%

Assessment of Hepatocellular Carcinoma Ablation Margins Using Fused Pre-ablation Hepatobiliary Phase and Post-ablation Unenhanced T1-weighted Images

Takeyama

Mizobuchi

Sakaki

et al. 2019

Showa Univ J Med Sci

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This study retrospectively investigated the value of fusing a pre-ablation hepatobiliary phase HBP series and post-ablation unenhanced T1-weighted images T1WIs to evaluate the treatment effectiveness of radiofrequency ablation for hepatocellular carcinoma HCC. Predictors of local tumor progression LTP were also identi ed. Our study comprised 47 patients with 88 HCCs 2 years follow up who underwent pre-ablation gadoxetate disodium-enhanced magnetic resonance imaging and post-ablation T1-weighted imaging. For the new assessment, pre-ablation HBP series and post-ablation T1WIs were fused using a rigid registration and manual correlation, and the ablation margin appearance was classi ed as ablation margin , ablation margin zero, ablation margin , or indeterminate index tumor was invisible based on the post-ablation T1WIs and fusion images. The minimal ablation margin was measured and clinical factors were investigated to identify other risk factors for LTP, which was observed in 14 tumors. The mean minimal ablation margin was 1.9 mm, excluding 5 indeterminate nodules without LTP, and 8 ablation margin-zero HCCs with LTP, with multivariate logistic regression analysis showing that the likelihood of ablation margin was inversely proportional to tumor size. The independent risk factors for LTP were not identi ed, but the cumulative LTP rates 0 at 1, 2, and 3 years in 41 ablation margin nodules were signi cantly lower P 0.005 than those 8.8 , 17.6 , and 17.6 at 1, 2, and 3 years, respectively in 34 ablation margin-zero nodules. In conclusion, fusion images might show an early therapeutic response of the ablated tumors in the majority of HCC cases.

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Section: Discussionmentioning

confidence: 77%

Assessment of Hepatocellular Carcinoma Ablation Margins Using Fused Pre-ablation Hepatobiliary Phase and Post-ablation Unenhanced T1-weighted Images

Takeyama

Mizobuchi

Sakaki

et al. 2019

Showa Univ J Med Sci

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“…Additional, in some previous studies, they try to use intelligent software for fused pre-and post-treatment imaging. 13,16 It had more accuracy for evaluating the ablation margin than manual registration, but it was not available in our department. We concluded that a large ablative volume was the independent factor for predicting higher intrahepatic recurrence-free survival and decreased risk of LTP.…”

Section: Discussionmentioning

confidence: 99%

“…Additional, in some previous studies, they try to use intelligent software for fused pre- and post-treatment imaging. 13 16 It had more accuracy for evaluating the ablation margin than manual registration, but it was not available in our department.…”

Section: Discussionmentioning

confidence: 99%

Ablative Volume of Radiofrequency Ablation Related to Intrahepatic Recurrence-Free Survival of Hepatocellular Carcinoma

Inmutto

Thaimai

Srisuwan

et al. 2021

The Arab Journal of Interventional Radiology

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Purpose The aim of this study was to evaluate intrahepatic recurrence-free survival of hepatocellular carcinoma (HCC) after Radiofrequency ablation (RFA) Methods A retrospective cohort study of single HCC treated by RFA between 2015 and 2017. Fifty patients were enrolled in the study. Tumor volume and ablative volume were measured by using Syngo.via application (Siemen Healthineers, United States). Ablative volume classified into small and large ablative volumes. Ablative margin was evaluated by visual comparison between pre- and post-RFA images and classified into two groups: closed ablative margin (<0.5cm) and large ablative margin (>0.5 cm). The recurrence tumor was classified as local tumor progression (LTP) and intrahepatic distant recurrence (IDR). The recurrence-free survival rate and independent risk for tumor recurrence were analyzed. Results Recurrence-free survival rate at the first, second, third, and fourth year after RFA was 83, 56, 44, and 44%, respectively. The average recurrence-free survival time in large ablative volume group was significantly longer than small ablative volume group (31.57 vs. 8.50 months, p = 0.003). A significant independent risk factor for tumor recurrence was large ablative volume (hazard ratio = 0.12, 95% confidence interval = 0.02–0.84, p = 0.033). The IDR group had ratio of actual ablative volume by ideal ablative volume (ablative ratio) higher than LTP group and nonrecurrent group. Conclusion The large ablative volume prevented tumor recurrence and increased recurrence-free survival rate. But aggressive ablation with high ablative volume ratio could increase risk of IDR.

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“…The cumulative local tumor progression rates in AM( +) HCCs were significantly lower than those in AM zero HCCs [ 39 ]. More recently, in a retrospective study of 29 patients, Takeyama et al [ 40 ] reported that the ablation margin status (AM( +), ablation margin completely surrounding the tumor vs. AM zero, a partially discontinuous ablation margin without protrusion of HCC) assessed using fusion images of pre- and post-ablation HBP series was an independent predictor for local tumor progression.…”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance imaging for treatment response evaluation and prognostication of hepatocellular carcinoma after thermal ablation

2023

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Hepatocellular carcinoma (HCC) accounts for the vast majority of primary liver cancer and constitutes a major global health challenge. Tumor ablation with either radiofrequency ablation (RFA) or microwave ablation (MWA) is recommended as a curative-intent treatment for early-stage HCC. Given the widespread use of thermal ablation in routine clinical practice, accurate evaluation of treatment response and patient outcomes has become crucial in optimizing individualized management strategies. Noninvasive imaging occupies the central role in the routine management of patients with HCC. Magnetic resonance imaging (MRI) could provide full wealth of information with respect to tumor morphology, hemodynamics, function and metabolism. With accumulation of liver MR imaging data, radiomics analysis has been increasingly applied to capture tumor heterogeneity and provide prognostication by extracting high-throughput quantitative imaging features from digital medical images. Emerging evidence suggests the potential role of several qualitative, quantitative and radiomic MRI features in prediction of treatment response and patient prognosis after ablation of HCC. Understanding the advancements of MRI in the evaluation of ablated HCCs may facilitate optimal patient care and improved outcomes. This review provides an overview of the emerging role of MRI in treatment response evaluation and prognostication of HCC patients undergoing ablation. Clinical relevance statement MRI-based parameters can help predict treatment response and patient prognosis after HCC ablation and thus guide treatment planning. Key points ECA-MRI provides morphological and hemodynamic assessment of ablated HCC. EOB-MRI provides more information for tumor response prediction after ablation. DWI improve the characterization of HCC and optimize treatment decision. Radiomics analysis enables characterization of tumor heterogeneity guidance of clinical decision-making. Further studies with multiple radiologists and sufficient follow-up period are needed. Graphical abstract

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Evaluation of hepatocellular carcinoma ablative margins using fused pre- and post-ablation hepatobiliary phase images

Cited by 12 publications

References 31 publications

Assessment of Hepatocellular Carcinoma Ablation Margins Using Fused Pre-ablation Hepatobiliary Phase and Post-ablation Unenhanced T1-weighted Images

Assessment of Hepatocellular Carcinoma Ablation Margins Using Fused Pre-ablation Hepatobiliary Phase and Post-ablation Unenhanced T1-weighted Images

Ablative Volume of Radiofrequency Ablation Related to Intrahepatic Recurrence-Free Survival of Hepatocellular Carcinoma

Magnetic resonance imaging for treatment response evaluation and prognostication of hepatocellular carcinoma after thermal ablation

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