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Published in: International Journal of Computer Assisted Radiology and Surgery 12/2018

Open Access 01-12-2018 | Original Article

Can tumor coverage evaluated 24 h post-radiofrequency ablation predict local tumor progression of liver metastases?

Authors: Frederik Vandenbroucke, Jef Vandemeulebroucke, Nico Buls, Ruedi F. Thoeni, Johan de Mey

Published in: International Journal of Computer Assisted Radiology and Surgery | Issue 12/2018

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Abstract

Purpose

To assess the predictive value for local tumor progression (LTP) of geometrical tumor coverage using the contrast-enhanced (ce-)CT images acquired before and within 24 h after radiofrequency (RF) ablation.

Methods

Twenty patients (6 male and 14 female, median age 62 years) with 45 focal hypovascular liver metastases (16 colorectal carcinoma, 3 melanoma and 1 breast carcinoma) underwent RF ablation under CT-guidance and received a ce-PET/CT scan within 24 h post-procedure. Pre- and post-ablation ce-CT-images were aligned using an interactive procedure and used to verify the tumor coverage of the RF ablation. Results were correlated to LTP as recorded during follow-up performed every 2–3 months after the intervention (mean follow-up of 110 weeks) and compared to standard reading performed by three readers of the ce-CT images.

Results

Eleven tumors (25%) showed LTP during the follow-up period. One lesion, which did not show LTP, was excluded from analysis due to the poor quality of the alignment. For the remaining, 29 (66%) tumors were completely covered by the ablation zone, 9 (20%) were not, and for 6 (14%) tumors the edges coincided with the edge of the ablation zone. The sensitivity, specificity, PPV and NPV for LTP of having incomplete tumor coverage or no apparent ablative margin versus standard reading of ce-CT were 100, 88, 73 and 100% versus 42, 88, 58 and 82%, respectively.

Conclusions

Verifying the tumor coverage of liver metastases by an ablation zone through alignment of pre- and early post-ablation ce-CT images has a high predictive value for LTP.
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Metadata
Title
Can tumor coverage evaluated 24 h post-radiofrequency ablation predict local tumor progression of liver metastases?
Authors
Frederik Vandenbroucke
Jef Vandemeulebroucke
Nico Buls
Ruedi F. Thoeni
Johan de Mey
Publication date
01-12-2018
Publisher
Springer International Publishing
Published in
International Journal of Computer Assisted Radiology and Surgery / Issue 12/2018
Print ISSN: 1861-6410
Electronic ISSN: 1861-6429
DOI
https://doi.org/10.1007/s11548-018-1765-z

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