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Open Access 01-06-2017 | Oncology

MR and CT imaging characteristics and ablation zone volumetry of locally advanced pancreatic cancer treated with irreversible electroporation

Authors: Laurien G. P. H. Vroomen, Hester J. Scheffer, Marleen C. A. M. Melenhorst, Marcus C. de Jong, Janneke E. van den Bergh, Cornelis van Kuijk, Foke van Delft, Geert Kazemier, Martijn R. Meijerink

Published in: European Radiology | Issue 6/2017

Abstract

Objectives

To assess specific imaging characteristics after irreversible electroporation (IRE) for locally advanced pancreatic carcinoma (LAPC) with contrast-enhanced (ce)MRI and ceCT, and to explore the correlation of these characteristics with the development of recurrence.

Methods

Qualitative and quantitative analyses of imaging data were performed on 25 patients treated with percutaneous IRE for LAPC. Imaging characteristics of the ablation zone on ceCT and ceMRI were assessed over a 6-month follow-up period. Contrast ratio scores between pre- and post-treatment were compared. To detect early imaging markers for treatment failure, attenuation characteristics at 6 weeks were linked to the area of recurrence within 6 months.

Results

Post-IRE, diffusion-weighted imaging (DWI)-b800 signal intensities decreased in all cases (p < 0.05). Both ceMRI and ceCT revealed absent or decreased contrast enhancement, with a hyperintense rim on ceMRI. Ablation zone volume increase was noted on both modalities in the first 6 weeks, followed by a decrease (p < 0.05). In the patients developing tumour recurrence (5/25), a focal DWI-b800 hyperintense spot at 6 weeks predated unequivocal recurrence on CT.

Conclusion

The most remarkable signal alterations after pancreatic IRE were shown by DWI-b800 and ceMRI. These early imaging characteristics may be useful to establish technical success and predict treatment outcome.

Key Points

• This study describes imaging characteristics after irreversible electroporation (IRE) for pancreatic adenocarcinoma.

• Familiarity with typical post-IRE imaging characteristics helps to interpret ablation zones.

• Post-IRE, no central and variable rim enhancement are visible on contrast-enhanced imaging.

• DWI-b800 may prove useful to predict early tumour recurrence.

• Post-IRE examinations reveal an initial volume increase followed by a decrease.

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Title: MR and CT imaging characteristics and ablation zone volumetry of locally advanced pancreatic cancer treated with irreversible electroporation
Authors: Laurien G. P. H. Vroomen
Hester J. Scheffer
Marleen C. A. M. Melenhorst
Marcus C. de Jong
Janneke E. van den Bergh
Cornelis van Kuijk
Foke van Delft
Geert Kazemier
Martijn R. Meijerink
Publication date: 01-06-2017
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 6/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-016-4581-2

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MR and CT imaging characteristics and ablation zone volumetry of locally advanced pancreatic cancer treated with irreversible electroporation

Abstract

Objectives

Methods

Results

Conclusion

Key Points

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Key Points

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