CardioVascular and Interventional Radiology

, Volume 33, Issue 2, pp 297–306 | Cite as

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

  • Sebastian KeilEmail author
  • Philipp Bruners
  • Katharina Schiffl
  • Martin Sedlmair
  • Georg Mühlenbruch
  • Rolf W. Günther
  • Marco Das
  • Andreas H. Mahnken
Clinical Investigation


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.


Hepatic metastases Radiofrequency ablation Automated evaluation 


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Copyright information

© Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2009

Authors and Affiliations

  • Sebastian Keil
    • 1
    Email author
  • Philipp Bruners
    • 1
    • 4
  • Katharina Schiffl
    • 2
  • Martin Sedlmair
    • 3
  • Georg Mühlenbruch
    • 1
  • Rolf W. Günther
    • 1
  • Marco Das
    • 1
  • Andreas H. Mahnken
    • 1
    • 4
  1. 1.Department of Diagnostic RadiologyUniversity Hospital, RWTH Aachen UniversityAachenGermany
  2. 2.Institute of Medical StatisticsUniversity Hospital, RWTH Aachen UniversityAachenGermany
  3. 3.Siemens HealthcareForchheimGermany
  4. 4.Applied Medical Engineering, Helmholtz InstituteRWTH Aachen UniversityAachenGermany

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