CT-guided Thermal Ablation of Liver Tumors Using Intraprocedural CT-CT Fusion for Applicator Position and Ablation Completeness Assessment: a Single-Center Comparative Analysis.
Koen H M Verdonschot, Sjoerd F M Jenniskens, Peter B van den Boezem, Eric T T L Tjwa, Johannes H W de Wilt, Jurgen J Fütterer, Martijn W J Stommel, Christiaan G Overduin
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引用次数: 0
Abstract
Purpose: To compare outcomes of CT-guided thermal ablation of liver tumors with versus without use of intraprocedural CT-CT image fusion.
Materials and methods: This retrospective cohort study included all patients treated with CT-guided percutaneous thermal ablation for hepatocellular carcinoma (HCC) or colorectal liver metastases (CRLM) between January 2017 and April 2023 at our institution. From October 2019, intraprocedural CT-CT deformable image fusion (IF) using dedicated software (Vitrea, Canon Medical) was introduced to the thermal ablation procedure workflow to visually assess applicator placement before ablation and ablation completeness posttreatment. Local tumor progression (LTP) was assessed on follow-up imaging. LTP-free survival (LTPFS) between groups with and without IF was estimated with the Kaplan-Meier method and risk factors for LTP were identified with Cox regression analysis.
Results: A total of 113 patients treated in 139 sessions were included; 66 treatments for 86 tumors without use of IF (56 HCC; 30 CRLM) and 73 treatments for 92 tumors with use of IF (46 HCC; 46 CRLM). Two-year LTPFS was significantly improved with use of IF for both HCC (97% vs. 74%; p = .009) and CRLM (82% vs. 56%; p = .033). On univariate regression analysis, use of IF was a predominant factor significantly associated with improved LTPFS in patients with HCC (HR: 0.21, p = .037) and CRLM (HR: 0.38, p = .042).
Conclusion: In this single-center study, the use of software-based intraprocedural CT-CT image fusion for applicator position and ablation completeness assessment was associated with improved local tumor progression-free survival after CT-guided thermal ablation of HCC and CRLM.
期刊介绍：
CardioVascular and Interventional Radiology (CVIR) is the official journal of the Cardiovascular and Interventional Radiological Society of Europe, and is also the official organ of a number of additional distinguished national and international interventional radiological societies. CVIR publishes double blinded peer-reviewed original research work including clinical and laboratory investigations, technical notes, case reports, works in progress, and letters to the editor, as well as review articles, pictorial essays, editorials, and special invited submissions in the field of vascular and interventional radiology. Beside the communication of the latest research results in this field, it is also the aim of CVIR to support continuous medical education. Articles that are accepted for publication are done so with the understanding that they, or their substantive contents, have not been and will not be submitted to any other publication.
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