Three-Dimensional Measurement of Hepatocellular Carcinoma Ablation Zones and Margins for Predicting Local Tumor Progression

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• 作者：Arnaud Hocquelet ; MD^a ; ^{arnaud.hocquelet@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Hervé ; Trillaud ; MD ; PhD^a ; Nora Frulio ; MD^a ; Panteleimon Papadopoulos ; MD^a ; Pierre Balageas ; MD^a ; Cé ; cile Salut ; MD^a ; Marie Meyer ; MD^a ; Jean-Fré ; dé ; ric Blanc ; MD ; PhD^b ; Michel Montaudon ; MD ; PhD^c ; Baudouin Denis de Senneville ; PhD^d
• 关键词：AFP ; α-fetoprotein ; DSC ; DICE similarity coefficient ; HCC ; hepatocellular carcinoma ; LTP ; local tumor progression ; RF ; radiofrequency ; ROI ; region of interest ; 3D ; three-dimensional ; THRIVE ; T1 high resolution isotropic volume excitation
• 刊名：Journal of Vascular and Interventional Radiology
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：27
• 期：7
• 页码：1038-1045.e2
• 全文大小：1777 K

文摘

To propose a postprocessing technique that measures tumor surface with insufficient ablative margins (≤ 5 mm) on magnetic resonance (MR) imaging to predict local tumor progression (LTP) following radiofrequency (RF) ablation.

Materials and Methods

A diagnostic method is proposed based on measurement of tumor surface with a margin ≤ 5 mm on MR imaging. The postprocessing technique includes fully automatic registration of pre- and post–RF ablation MR imaging, a semiautomatic segmentation of pre–RF ablation tumor and post–RF ablation volume, and a subsequent calculation of the three-dimensional exposed tumor surface area. The ability to use this surface margin ≤ 5 mm to predict local recurrence at 2 years was then tested on 16 patients with cirrhosis who were treated by RF ablation with a margin ≤ 5 mm in 2012: eight with LTP matched according to tumor size and number and α-fetoprotein level versus eight without local recurrence.

Results

The error of estimated tumor surface with a margin ≤ 5 mm was less than 12%. Results of a log-rank test showed that patients with a tumor surface area > 425 mm² had a 2-year LTP rate of 77.5%, compared with 25% for patients with a tumor surface area ≤ 425 mm² (P = .018).

Conclusions

This proof-of-concept study proposes an accurate and reliable postprocessing technique to estimate tumor surface with insufficient ablative margins, and underscores the potential usefulness of tumor surface with a margin ≤ 5 mm to stratify patients with HCC treated by RF ablation according to their risk of LTP.