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

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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//28/0volume. 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 lnQ28/0attenuation (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//28/0volume/RECIST/WHO/attenuation) was introduced, which appears to be of prognostic value at early follow-up CT.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, University Hospital, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany

    Sebastian Keil, Philipp Bruners, Georg Mühlenbruch, Rolf W. Günther, Marco Das & Andreas H. Mahnken

  2. Institute of Medical Statistics, University Hospital, RWTH Aachen University, 52074, Aachen, Germany

    Katharina Schiffl

  3. Siemens Healthcare, Forchheim, Germany

    Martin Sedlmair

  4. Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, 52074, Aachen, Germany

    Philipp Bruners & Andreas H. Mahnken

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  1. Sebastian Keil
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  2. Philipp Bruners
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  3. Katharina Schiffl
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  4. Martin Sedlmair
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  7. Marco Das
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  8. Andreas H. Mahnken
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Correspondence to Sebastian Keil.

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Keil, S., Bruners, P., Schiffl, K. et al. Radiofrequency Ablation of Liver Metastases—Software-Assisted Evaluation of the Ablation Zone in MDCT: Tumor-Free Follow-Up Versus Local Recurrent Disease. Cardiovasc Intervent Radiol 33, 297–306 (2010). https://doi.org/10.1007/s00270-009-9681-9

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  • DOI: https://doi.org/10.1007/s00270-009-9681-9

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