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Unenhanced magnetic resonance imaging immediately after radiofrequency ablation of liver malignancy: preliminary results

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Abstract

Purpose

To assess the accuracy of unenhanced magnetic resonance imaging (MRI) immediately after the percutaneous ultrasound-guided radiofrequency ablation (RFA) of liver malignancy in predicting treatment efficacy at CT follow-up.

Materials and methods

Percutaneous ablation was prospectively performed in 23 liver malignancies (20 hepatocarcinomas and 3 metastases). After the procedure in the same day all patients were studied with unenhanced MRI. The best sequence to detect the coagulative necrosis was visually established. Pre-RFA CT and post-RFA MRI were registered with non-rigid transformation algorithm. Manual segmentation of lesions and ablated areas in pre-RFA CT, post-RFA MRI, and follow-up CT were obtained. Sensitivity, specificity, positive predictive value (PPV), negative predicitve value (NPV), and accuracy of MRI in predicting the correct centering and the complete treatment of the lesion were calculated in respect to the 1-month follow-up CT.

Results

Fat-saturated T1-weighted (fs T1-w) was the sequence in which the best conspicuity of the ablated area was depicted. Coagulative necrosis was hyperintense in fs T1-w sequence in 17/23 (74%). In respect to follow-up CT, MRI predicted the correct centering of the lesions in 19/20 lesions with sensitivity, specificity, PPV, NPV, and accuracy of 100%, 75%, 95%, 100%, and 100%, respectively. MRI predicted the complete treatment of the lesions in 17/17 lesions with sensitivity, specificity, PPV, NPV, and accuracy of 100%.

Conclusion

MRI with the single fs T1-w sequence was highly accurate in predicting the treatment efficacy of percutaneous ablation of liver malignancies in comparison to follow-up CT control. Unnecessary CT in case of incomplete treatment can be therefore easily avoided.

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Authors and Affiliations

  1. Department of Radiology, G.B. Rossi Hospital, University of Verona, Piazzale L.A. Scuro, 10, 37134, Verona, Italy

    Mirko D’Onofrio, Nicolò Cardobi, Valentina Ciaravino & Roberto Pozzi Mucelli

  2. Department of Hepatobiliary Surgery, G.B. Rossi Hospital, University of Verona, Piazzale L.A. Scuro, 10, 37134, Verona, Italy

    Andrea Ruzzenente, Simone Conci & Alfredo Guglielmi

Authors
  1. Mirko D’Onofrio
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  2. Nicolò Cardobi
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  3. Andrea Ruzzenente
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  4. Simone Conci
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  5. Valentina Ciaravino
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  6. Alfredo Guglielmi
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  7. Roberto Pozzi Mucelli
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Corresponding author

Correspondence to Mirko D’Onofrio.

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Funding

The present study did not receive any funding support.

Conflict of interest

All the authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Research involving human participants and/or animals

This article does not contain any studies with animals performed by any of the authors.

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D’Onofrio, M., Cardobi, N., Ruzzenente, A. et al. Unenhanced magnetic resonance imaging immediately after radiofrequency ablation of liver malignancy: preliminary results. Abdom Radiol 43, 1379–1385 (2018). https://doi.org/10.1007/s00261-017-1299-9

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  • DOI: https://doi.org/10.1007/s00261-017-1299-9

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