Comparative evaluation of three-dimensional Gd-EOB-DTPA-enhanced MR fusion imaging with CT fusion imaging in the assessment of treatment effect of radiofrequency ablation of hepatocellular carcinoma
- 549 Downloads
To assess the feasibility of fusion of pre- and post-ablation gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (Gd-EOB-DTPA-MRI) to evaluate the effects of radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC), compared with similarly fused CT images
Patients and methods
This retrospective study included 67 patients with 92 HCCs treated with RFA. Fusion images of pre- and post-RFA dynamic CT, and pre- and post-RFA Gd-EOB-DTPA-MRI were created, using a rigid registration method. The minimal ablative margin measured on fusion imaging was categorized into three groups: (1) tumor protruding outside the ablation zone boundary, (2) ablative margin 0–<5.0 mm beyond the tumor boundary, and (3) ablative margin ≥5.0 mm beyond the tumor boundary. The categorization of minimal ablative margins was compared between CT and MR fusion images.
In 57 (62.0%) HCCs, treatment evaluation was possible both on CT and MR fusion images, and the overall agreement between them for the categorization of minimal ablative margin was good (κ coefficient = 0.676, P < 0.01). MR fusion imaging enabled treatment evaluation in a significantly larger number of HCCs than CT fusion imaging (86/92 [93.5%] vs. 62/92 [67.4%], P < 0.05).
Fusion of pre- and post-ablation Gd-EOB-DTPA-MRI is feasible for treatment evaluation after RFA. It may enable accurate treatment evaluation in cases where CT fusion imaging is not helpful.
KeywordsHepatocellular carcinoma Radiofrequency ablation Fusion imaging Ablative margin Gd-EOB-DTPA
- 5.Niculescu G, Foran DJ, Nosher J (2007) Non-rigid registration of the liver in consecutive CT studies for assessment of tumor response to radiofrequency ablation. Conf Proc IEEE Eng Med Biol Soc 2007:856–859Google Scholar
- 7.Kim YS, Lee WJ, Rhim H, et al. (2010) The minimal ablative margin of radiofrequency ablation of hepatocellular carcinoma (>2 and <5 cm) needed to prevent local tumor progression: 3D quantitative assessment using CT image fusion. AJR Am J Roentgenol 195:758–765. doi: 10.2214/AJR.09.2954 PubMedCrossRefGoogle Scholar
- 24.Abi-Jaoudeh N, Mielekamp P, Noordhoek N, et al. (2012) Cone-beam computed tomography fusion and navigation for real-time positron emission tomography-guided biopsies and ablations: a feasibility study. J Vasc Interv Radiol 23:737–743. doi: 10.1016/j.jvir.2012.02.006 PubMedCentralPubMedCrossRefGoogle Scholar
- 29.Yoon JH, Lee EJ, Cha SS, et al. (2010) Comparison of gadoxetic acid-enhanced MRI versus four-phase multi-detector row computed tomography in assessing tumor regression after radiofrequency ablation in subjects with hepatocellular carcinomas. J Vasc Interv Radiol 21:348–356. doi: 10.1016/j.jvir.2009.11.014 PubMedCrossRefGoogle Scholar
- 30.Crum WR, Hartkens T, Hill DL (2004) Non-rigid image registration: theory and practice. Br J Radiol 77(Spec No 2):S140–53Google Scholar
- 33.Koda M, Tokunaga S, Fujise Y, et al. (2012) Assessment of ablative margin after radiofrequency ablation for hepatocellular carcinoma; comparison between magnetic resonance imaging with ferucarbotran and enhanced CT with iodized oil deposition. Eur J Radiol 81:1400–1404. doi: 10.1016/j.ejrad.2011.03.004 PubMedCrossRefGoogle Scholar