Role of MRI in the assessment of treatment response after radiofrequency and microwave ablation therapy for hepatocellular carcinoma

Mahmoud, Bahaa Eldin; Elkholy, Shaima Fatooh; Nabeel, Mohamed Mahmoud; Abdelaziz, Ashraf Omar; Elbaz, Tamer; Shousha, Hend Ibrahim; Ibrahim, Mukdad; Hashem, Ahmed T.; Ramadan, Ahmed; Abdelmaksoud, Ahmed Hosni

doi:10.1016/j.ejrnm.2016.01.007

Cited by 11 publications

(8 citation statements)

References 11 publications

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“…Mahmoud et al 39 showed that T2-weighted images were superior to other weighted images in detecting liver cancer. Therefore, T2w-4DMRI is a promising technique for clinical liver tumor delineation and was used in our study.…”

Section: Discussionmentioning

confidence: 99%

Comparative Evaluation of 4-Dimensional Computed Tomography and 4-Dimensional Magnetic Resonance Imaging to Delineate the Target of Primary Liver Cancer

Gong

Wang

Liu

et al. 2021

Technol Cancer Res Treat

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Purpose: To evaluate the feasibility of 4-dimensional magnetic resonance imaging (4DMRI) in establishing the target of primary liver cancer in comparison with 4-dimensional computed tomography (4DCT). Methods and Materials: A total of 23 patients with primary liver cancer who received radiotherapy were selected, and 4DCT and T2w-4DMRI simulations were conducted to obtain 4DCT and T2w-4DMRI simulation images. The 4DCT and T2w-4DMRI data were sorted into 10 and 8 respiratory phase bins, respectively. The liver and gross tumor volumes (GTVs) were delineated in all images using programmed clinical workflows under tumor delineation guidelines. The internal organs at risk volumes (IRVs) and internal target volumes (ITVs) were the unions of all the phase livers and GTVs, respectively. Then, the artifacts, liver volume, GTV, and motion range in 4DCT and T2w-4DMRI were compared. Results: The mean GTV volume based on 4DMRI was 136.42 ± 231.27 cm3, which was 25.04 cm3 (15.5%) less than that of 4DCT (161.46 ± 280.29 cm3). The average volume of ITV determined by 4DMRI was 166.12 ± 270.43 cm3, which was 22.44 cm3 (11.9%) less than that determined by 4DCT (188.56 ± 307.57 cm3). Liver volume and IRV in 4DMRI increased by 4.0% and 6.6%, respectively, compared with 4DCT. The difference in tumor motion by T2w-4DMRI based on the centroid was greater than that of 4DCT in the L/R, A/P, and S/I directions, and the average displacement differences were 2.6, 2.8, and 6.9 mm, respectively. The severe artifacts in 4DCT were 47.8% (11/23) greater than in 4DMRI 17.4% (4/23). Conclusions: Compared with 4DCT, T2-weighted and navigator-triggered 4DMRI produces fewer artifacts and larger motion differences in hepatic intrafraction tumors, which is a feasible technique for primary liver cancer treatment planning.

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Section: Discussionmentioning

confidence: 99%

Comparative Evaluation of 4-Dimensional Computed Tomography and 4-Dimensional Magnetic Resonance Imaging to Delineate the Target of Primary Liver Cancer

Gong

Wang

Liu

et al. 2021

Technol Cancer Res Treat

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“…Mahmoud et al, in their study, documented significantly lower mean ADC values (0.91 ± 0.09) in the recurrent lesions as compared with ablation zone (1.36 ± 0.18) or postablation images (1.29 ± 0.12). 49 Positron emission tomography (PET)-CT can be used for early detection of recurrent disease in those patients where preablation PET-CT showed F-fluorodeoxyglucose -avid lesions. 18 Imaging appearance of remote intrahepatic distant recurrence and extrahepatic recurrence/metastasis is like that of a nonablated lesion.…”

Section: Evidence and Rationalementioning

confidence: 99%

Indian Society of Vascular and Interventional Radiology Expert Consensus Statements for Ablation in Hepatocellular Carcinoma: Part II

Gupta

Keshava

Kalra

et al. 2020

Journal of Clinical Interventional Radiology ISVIR

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Locoregional therapies play an important role in the management of hepatocellular carcinoma (HCC). Percutaneous ablation is one of the most commonly employed nonsurgical methods for treating very early and early HCC. For small HCC, ablation is potentially curative and competes with surgical resection. The widespread availability and the spectrum of ablative techniques mandate uniform approach among interventional radiologists. Thus, it is desirable to have a consensus regarding various aspects of the liver ablation. This article represents a consensus document of the experts from the Indian Society of Vascular and Interventional Radiology involved in the care of patients with HCC. The statements are presented in two parts.

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“…Surgical resection remains for a long time as the gold standard therapy for HCC. Liver transplantation is another treatment option; however, tumors are resectable or meet transplantation criteria in only 5-10% of patients at the time of diagnosis [3,4].…”

Section: Introductionmentioning

confidence: 99%

“…Dynamic subtraction MRI is a technique used to remove the pre-existing high T1 signal from the postprocessed images. The corresponding contrast-enhanced and unenhanced T1-weighted sequences are digitally subtracted image-by-image using post processing MRI software so that any native T1 signal is removed and the remaining high signal on the post processed subtracted images is solely due to enhancement [3].…”

Section: Introductionmentioning

confidence: 99%

The value of dynamic subtraction MRI technique in the assessment of treatment response of hepatocellular carcinoma to transcatheter arterial chemoembolization

Metwally

Mahmoud

Yehia

2019

Egypt J Radiol Nucl Med

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Background: Hepatocellular carcinoma is considered to be the fifth most common cancer worldwide. Resection and liver transplantation have a high survival in the correct clinical scenarios; however, locoregional therapy has many advantages over tumor resection like preservation of hepatic parenchyma and overall less morbidity and mortality. Our aim was to present the role of dynamic subtraction MRI technique in the assessment of treatment response of hepatocellular carcinoma to transarterial chemoembolization. Methods: The study consisted of 43 patients with 55 hepatocellular carcinoma lesions who underwent transarterial chemoembolization procedure and followed up by dynamic MRI of the liver with post processing to obtain subtraction images 1-1.5 months after the procedure. If no signs of disease activity, another follow up study was preformed 2-4 months later. Five patients were excluded due to misregistration artifact at the subtraction images. The final cohort is 38 patients having 50 lesions. Precontrast T1, T2, dynamic contrast enhanced, and diffusion-weighted images were acquired. Subtracted dynamic images were created on the workstation. Sequences were assessed by three experienced readers in hepatic imaging. The sensitivity, specificity, positive predictive value, negative predictive value, 95% confidence interval, and overall agreement were calculated for the dynamic and subtracted dynamic images.Results: The subtraction images have sensitivity of 96%, specificity of 100%, PPV of 100%, and NPV of 100% Compared to 96%, 100%, 100%, 96%, and 96%, 100%, 100% 96% for the three readers respectively. On the other hand, the dynamic images has sensitivity of 92%, specificity of 96%, PPV of 95%, and NPV of 92.3% compared to 92%, 96%, 95%, 92.3% and 80%, 68%, 71.4%, and 77.2% for the three readers respectively.Conclusion: Subtraction technique is a useful confirmative tool as it had higher sensitivity, specificity, PPV, and NPV values compared to the dynamic and diffusion images with high level of agreement between the readers and also associated with significantly higher reader confidence levels.

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Role of MRI in the assessment of treatment response after radiofrequency and microwave ablation therapy for hepatocellular carcinoma

Cited by 11 publications

References 11 publications

Comparative Evaluation of 4-Dimensional Computed Tomography and 4-Dimensional Magnetic Resonance Imaging to Delineate the Target of Primary Liver Cancer

Comparative Evaluation of 4-Dimensional Computed Tomography and 4-Dimensional Magnetic Resonance Imaging to Delineate the Target of Primary Liver Cancer

Indian Society of Vascular and Interventional Radiology Expert Consensus Statements for Ablation in Hepatocellular Carcinoma: Part II

The value of dynamic subtraction MRI technique in the assessment of treatment response of hepatocellular carcinoma to transcatheter arterial chemoembolization

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