Pim Hendriks , Kiki M van Dijk , Bas Boekestijn , Alexander Broersen , Jacoba J van Duijn-de Vreugd , Minneke J Coenraad , Maarten E Tushuizen , Arian R van Erkel , Rutger W van der Meer , Catharina SP van Rijswijk , Jouke Dijkstra , Lioe-Fee de Geus-Oei , Mark C Burgmans
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There were thirteen men and seven women with a mean age of 67.1 ± 10.8 (standard deviation [SD]) years (age range: 49.1–81.1 years). All patients underwent contrast-enhanced computed tomography examination under general anesthesia directly before and after TA, with preoxygenated breath hold. Contrast-enhanced computed tomography examinations were analyzed by radiologists using rigid registration software. Registration was deemed feasible when accurate rigid co-registration could be obtained. Inter- and intra-observer rates of tumor segmentation and MAM quantification were calculated. MAM values were correlated with local tumor progression (LTP) after one year of follow-up.</p></div><div><h3>Results</h3><p>Co-registration of pre- and post-ablation images was feasible in 16 out of 20 patients (80%) and 26 out of 31 tumors (84%). Mean Dice similarity coefficient for inter- and intra-observer variability of tumor segmentation were 0.815 and 0.830, respectively. Mean MAM was 0.63 ± 3.589 (SD) mm (range: -6.26–6.65 mm). LTP occurred in four out of 20 patients (20%). The mean MAM value for patients who developed LTP was -4.00 mm, as compared to 0.727 mm for patients who did not develop LTP.</p></div><div><h3>Conclusion</h3><p>Ablation margin quantification is feasible using a standardized contrast-enhanced computed tomography protocol. Interpretation of MAM was hampered by the occurrence of tissue shrinkage during TA. Further validation in a larger cohort should lead to meaningful cut-off values for technical success of TA.</p></div>","PeriodicalId":48656,"journal":{"name":"Diagnostic and Interventional Imaging","volume":null,"pages":null},"PeriodicalIF":4.9000,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S221156842300150X/pdfft?md5=5446a9590ead917701293c4bd42978aa&pid=1-s2.0-S221156842300150X-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Intraprocedural assessment of ablation margins using computed tomography co-registration in hepatocellular carcinoma treatment with percutaneous ablation: IAMCOMPLETE study\",\"authors\":\"Pim Hendriks , Kiki M van Dijk , Bas Boekestijn , Alexander Broersen , Jacoba J van Duijn-de Vreugd , Minneke J Coenraad , Maarten E Tushuizen , Arian R van Erkel , Rutger W van der Meer , Catharina SP van Rijswijk , Jouke Dijkstra , Lioe-Fee de Geus-Oei , Mark C Burgmans\",\"doi\":\"10.1016/j.diii.2023.07.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><p>The primary objective of this study was to determine the feasibility of ablation margin quantification using a standardized scanning protocol during thermal ablation (TA) of hepatocellular carcinoma (HCC), and a rigid registration algorithm. 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引用次数: 0
摘要
目的本研究的主要目的是确定在肝细胞癌（HCC）热消融（TA）过程中使用标准化扫描方案和刚性配准算法进行消融边缘量化的可行性。次要目标是确定肿瘤分割和最小消融边缘（MAM）量化的观察者间和观察者内变异性。其中男性 13 例，女性 7 例，平均年龄为 67.1 ± 10.8（标准差 [SD]）岁（年龄范围：49.1-81.1 岁）。所有患者在TA前后均在全身麻醉下直接接受了对比增强计算机断层扫描检查，并进行了预吸氧屏气。造影剂增强计算机断层扫描检查由放射科医生使用刚性配准软件进行分析。如果能获得准确的刚性联合配准，则认为配准是可行的。计算肿瘤分割和 MAM 定量的观察者间和观察者内比率。结果20例患者中有16例（80%）和31例肿瘤中有26例（84%）消融前后图像的联合登记是可行的。肿瘤分割的观察者间和观察者内变异的平均 Dice 相似系数分别为 0.815 和 0.830。平均 MAM 为 0.63 ± 3.589 (SD) mm（范围：-6.26-6.65 mm）。20 名患者中有 4 人（20%）出现了 LTP。出现 LTP 的患者的平均 MAM 值为 -4.00 mm，而未出现 LTP 的患者的平均 MAM 值为 0.727 mm。MAM的解释受到TA过程中组织收缩的影响。在更大的群体中进行进一步验证，应能为 TA 的技术成功找到有意义的临界值。
Intraprocedural assessment of ablation margins using computed tomography co-registration in hepatocellular carcinoma treatment with percutaneous ablation: IAMCOMPLETE study
Purpose
The primary objective of this study was to determine the feasibility of ablation margin quantification using a standardized scanning protocol during thermal ablation (TA) of hepatocellular carcinoma (HCC), and a rigid registration algorithm. Secondary objectives were to determine the inter- and intra-observer variability of tumor segmentation and quantification of the minimal ablation margin (MAM).
Materials and methods
Twenty patients who underwent thermal ablation for HCC were included. There were thirteen men and seven women with a mean age of 67.1 ± 10.8 (standard deviation [SD]) years (age range: 49.1–81.1 years). All patients underwent contrast-enhanced computed tomography examination under general anesthesia directly before and after TA, with preoxygenated breath hold. Contrast-enhanced computed tomography examinations were analyzed by radiologists using rigid registration software. Registration was deemed feasible when accurate rigid co-registration could be obtained. Inter- and intra-observer rates of tumor segmentation and MAM quantification were calculated. MAM values were correlated with local tumor progression (LTP) after one year of follow-up.
Results
Co-registration of pre- and post-ablation images was feasible in 16 out of 20 patients (80%) and 26 out of 31 tumors (84%). Mean Dice similarity coefficient for inter- and intra-observer variability of tumor segmentation were 0.815 and 0.830, respectively. Mean MAM was 0.63 ± 3.589 (SD) mm (range: -6.26–6.65 mm). LTP occurred in four out of 20 patients (20%). The mean MAM value for patients who developed LTP was -4.00 mm, as compared to 0.727 mm for patients who did not develop LTP.
Conclusion
Ablation margin quantification is feasible using a standardized contrast-enhanced computed tomography protocol. Interpretation of MAM was hampered by the occurrence of tissue shrinkage during TA. Further validation in a larger cohort should lead to meaningful cut-off values for technical success of TA.
期刊介绍：
Diagnostic and Interventional Imaging accepts publications originating from any part of the world based only on their scientific merit. The Journal focuses on illustrated articles with great iconographic topics and aims at aiding sharpening clinical decision-making skills as well as following high research topics. All articles are published in English.
Diagnostic and Interventional Imaging publishes editorials, technical notes, letters, original and review articles on abdominal, breast, cancer, cardiac, emergency, forensic medicine, head and neck, musculoskeletal, gastrointestinal, genitourinary, interventional, obstetric, pediatric, thoracic and vascular imaging, neuroradiology, nuclear medicine, as well as contrast material, computer developments, health policies and practice, and medical physics relevant to imaging.
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