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CardioVascular and Interventional Radiology

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01-04-2010 | Clinical Investigation

Radiofrequency Ablation of Liver Metastases—Software-Assisted Evaluation of the Ablation Zone in MDCT: Tumor-Free Follow-Up Versus Local Recurrent Disease

Authors: Sebastian Keil, Philipp Bruners, Katharina Schiffl, Martin Sedlmair, Georg Mühlenbruch, Rolf W. Günther, Marco Das, Andreas H. Mahnken

Published in: CardioVascular and Interventional Radiology | Issue 2/2010

Abstract

The purpose of this study was to investigate differences in change of size and CT value between local recurrences and tumor-free areas after CT-guided radiofrequency ablation (RFA) of hepatic metastases during follow-up by means of dedicated software for automatic evaluation of hepatic lesions. Thirty-two patients with 54 liver metastases from breast or colorectal cancer underwent triphasic contrast-enhanced multidetector-row computed tomography (MDCT) to evaluate hepatic metastatic spread and localization before CT-guided RFA and for follow-up after intervention. Sixteen of these patients (65.1 ± 10.3 years) with 30 metastases stayed tumor-free (group 1), while the other group (n = 16 with 24 metastases; 62.0 ± 13.8 years) suffered from local recurrent disease (group 2). Applying an automated software tool (SyngoCT Oncology; Siemens Healthcare, Forchheim, Germany), size parameters (volume, RECIST, WHO) and attenuation were measured within the lesions before, 1 day after, and 28 days after RFA treatment. The natural logarithm (ln) of the quotient of the volume 1 day versus 28 days after RFA treament was computed: lnQ1//28/0_volume. Analogously, ln ratios of RECIST, WHO, and attenuation were computed and statistically evaluated by repeated-measures ANOVA. One lesion in group 2 was excluded from further evaluation due to automated missegmentation. Statistically significant differences between the two groups were observed with respect to initial volume, RECIST, and WHO (p < 0.05). Furthermore, ln ratios corresponding to volume, RECIST, and WHO differed significantly between the two groups. Attenuation evaluations showed no significant differences, but there was a trend toward attenuation assessment for the parameter lnQ28/0_attenuation (p = 0.0527), showing higher values for group 1 (–0.4 ± 0.3) compared to group 2 (–0.2 ± 0.2). In conclusion, hepatic metastases and their zone of coagulation necrosis after RFA differed significantly between tumor-free and local-recurrent ablation zones with respect to the corresponding size parameters. A new parameter (lnQ1//28/0_{volume/RECIST/WHO/attenuation}) was introduced, which appears to be of prognostic value at early follow-up CT.

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Title: Radiofrequency Ablation of Liver Metastases—Software-Assisted Evaluation of the Ablation Zone in MDCT: Tumor-Free Follow-Up Versus Local Recurrent Disease
Authors: Sebastian Keil
Philipp Bruners
Katharina Schiffl
Martin Sedlmair
Georg Mühlenbruch
Rolf W. Günther
Marco Das
Andreas H. Mahnken
Publication date: 01-04-2010
Publisher: Springer-Verlag
Published in: CardioVascular and Interventional Radiology / Issue 2/2010
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-009-9681-9

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Springer Medicine

Radiofrequency Ablation of Liver Metastases—Software-Assisted Evaluation of the Ablation Zone in MDCT: Tumor-Free Follow-Up Versus Local Recurrent Disease

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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