Study Protocol COVER-ALL: Clinical Impact of a Volumetric Image Method for Confirming Tumour Coverage with Ablation on Patients with Malignant Liver Lesions

Lin, Yuan-Mao; Paolucci, Iwan; Anderson, Brian; O'Connor, Caleb S; Rigaud, B.; Briones-Dimayuga, Maria; Jones, A. Kyle; Brock, Kristy K.; Fellman, Bryan; Odisio, Bruno C.

doi:10.1007/s00270-022-03255-3

Cited by 11 publications

(4 citation statements)

References 30 publications

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“…Several prospective clinical trials are currently performed trying to bridge this gap, such as the PROMETHEUS (Netherlands Trial Register NL9713) [84] , ACCLAIM (Clinicaltrials.gov: NCT03753789), COVER-ALL (Clinicaltrials.gov: NCT04083378) [85] , RFA physics library – PGP (Clinicaltrials.gov: NCT04152343) and IAMCOMPLETE (Clinicaltrials.gov: NCT04123340) trials. Moreover, companies are developing solutions for ablation margin quantification and raising precision e.g.…”

Section: Discussionmentioning

confidence: 99%

Ablation margin quantification after thermal ablation of malignant liver tumors: How to optimize the procedure? A systematic review of the available evidence

Hendriks

Boel

Oosterveer

et al. 2023

European Journal of Radiology Open

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Section: Discussionmentioning

confidence: 99%

Ablation margin quantification after thermal ablation of malignant liver tumors: How to optimize the procedure? A systematic review of the available evidence

Hendriks

Boel

Oosterveer

et al. 2023

European Journal of Radiology Open

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“…Microwave antenna placement was performed by manual correction under intermittent CT image guidance. MAMs were evaluated using our novel ablation confirmation methodology intraprocedural [ 32 ]. The ablation confirmation uses Morfeus [ 33 ], a deformable image registration algorithm, to confirm ablation coverage.…”

Section: Methodsmentioning

confidence: 99%

Using Patient-Specific 3D Modeling and Simulations to Optimize Microwave Ablation Therapy for Liver Cancer

Heshmat,

O’Connor,

Albuquerque Marques Silva

et al. 2024

Cancers

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Microwave ablation (MWA) of liver tumors presents challenges like under- and over-ablation, potentially leading to inadequate tumor destruction and damage to healthy tissue. This study aims to develop personalized three-dimensional (3D) models to simulate MWA for liver tumors, incorporating patient-specific characteristics. The primary objective is to validate the predicted ablation zones compared to clinical outcomes, offering insights into MWA before therapy to facilitate accurate treatment planning. Contrast-enhanced CT images from three patients were used to create 3D models. The simulations used coupled electromagnetic wave propagation and bioheat transfer to estimate the temperature distribution, predicting tumor destruction and ablation margins. The findings indicate that prolonged ablation does not significantly improve tumor destruction once an adequate margin is achieved, although it increases tissue damage. There was a substantial overlap between the clinical ablation zones and the predicted ablation zones. For patient 1, the Dice score was 0.73, indicating high accuracy, with a sensitivity of 0.72 and a specificity of 0.76. For patient 2, the Dice score was 0.86, with a sensitivity of 0.79 and a specificity of 0.96. For patient 3, the Dice score was 0.8, with a sensitivity of 0.85 and a specificity of 0.74. Patient-specific 3D models demonstrate potential in accurately predicting ablation zones and optimizing MWA treatment strategies.

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“…Ablations were performed with radiofrequency (Cool-tip Radiofrequency Ablation System; Covidien) or microwave (NeuWave Medical; Ethicon) according to the operator's choice. All procedures were performed with the goal of achieving ablative margins ≥5 mm by comparing preablation and postablation contrast-enhanced CT images using a 2-dimensional anatomic landmarks-based margin visual assessment method, a commercialized intensity-based ablation confirmation software (NEUWAVE System; NeuWave Medical), or an investigational ablation confirmation software currently undergoing clinical evaluation 15 …”

Section: Methodsmentioning

confidence: 99%

Intraprocedural Versus Initial Follow-up Minimal Ablative Margin Assessment After Colorectal Liver Metastasis Thermal Ablation

Lin,

Paolucci,

Albuquerque Marques Silva

et al. 2023

Invest Radiol

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Objectives The aim of this study was to investigate the prognostic value of 3-dimensional minimal ablative margin (MAM) quantified by intraprocedural versus initial follow-up computed tomography (CT) in predicting local tumor progression (LTP) after colorectal liver metastasis (CLM) thermal ablation. Materials and Methods This single-institution, patient-clustered, tumor-based retrospective study included patients undergoing microwave and radiofrequency ablation between 2016 and 2021. Patients without intraprocedural and initial follow-up contrast-enhanced CT, residual tumors, or with follow-up less than 1 year without LTP were excluded. Minimal ablative margin was quantified by a biomechanical deformable image registration method with segmentations of CLMs on intraprocedural preablation CT and ablation zones on intraprocedural postablation and initial follow-up CT. Prognostic value of MAM to predict LTP was tested using area under the curve and competing-risk regression model. Results A total of 68 patients (mean age ± standard deviation, 57 ± 12 years; 43 men) with 133 CLMs were included. During a median follow-up of 30.3 months, LTP rate was 17% (22/133). The median volume of ablation zone was 27 mL and 16 mL segmented on intraprocedural and initial follow-up CT, respectively (P < 0.001), with corresponding median MAM of 4.7 mm and 0 mm, respectively (P < 0.001). The area under the curve was higher for MAM quantified on intraprocedural CT (0.89; 95% confidence interval [CI], 0.83–0.94) compared with initial follow-up CT (0.66; 95% CI, 0.54–0.76) in predicting 1-year LTP (P < 0.001). An MAM of 0 mm on intraprocedural CT was an independent predictor of LTP with a subdistribution hazards ratio of 11.9 (95% CI, 4.9–28.9; P < 0.001), compared with 2.4 (95% CI, 0.9–6.0; P = 0.07) on initial follow-up CT. Conclusions Ablative margin quantified on intraprocedural CT significantly outperformed initial follow-up CT in predicting LTP and should be used for ablation endpoint assessment.

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Study Protocol COVER-ALL: Clinical Impact of a Volumetric Image Method for Confirming Tumour Coverage with Ablation on Patients with Malignant Liver Lesions

Cited by 11 publications

References 30 publications

Ablation margin quantification after thermal ablation of malignant liver tumors: How to optimize the procedure? A systematic review of the available evidence

Ablation margin quantification after thermal ablation of malignant liver tumors: How to optimize the procedure? A systematic review of the available evidence

Using Patient-Specific 3D Modeling and Simulations to Optimize Microwave Ablation Therapy for Liver Cancer

Intraprocedural Versus Initial Follow-up Minimal Ablative Margin Assessment After Colorectal Liver Metastasis Thermal Ablation

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