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Abdominal Radiology

, Volume 44, Issue 3, pp 923–935 | Cite as

Evaluation of hepatocellular carcinoma ablative margins using fused pre- and post-ablation hepatobiliary phase images

  • Nobuyuki TakeyamaEmail author
  • Naruki Mizobuchi
  • Masashi Sakaki
  • Yu Shimozuma
  • Jiro Munechika
  • Atsushi Kajiwara
  • Manabu Uchikoshi
  • Syojiro Uozumi
  • Yoshimitsu Ohgiya
  • Takehiko Gokan
Article
  • 113 Downloads

Abstract

Purpose

To retrospectively evaluate the utility of fusion images of pre- and post-ablation hepatobiliary phase (HBP) series to assess the ablation margins after radiofrequency ablation (RFA) of hepatocellular carcinomas (HCCs). Additionally, to identify factors indicative of an adequate ablation margin and predictors of local tumor progression (LTP).

Methods

Fifty-nine HCCs in 29 patients were treated by RFA and followed-up for > 1 year (mean 37.9 months). Fusion images of pre- and post-ablation HBP series were created using a non-rigid registration and manual correlation. The ablation margin appearance was classified as ablation margin + (ablation margin completely surrounding the tumor), ablation margin-zero (a partially discontinuous ablation margin without protrusion of HCC), ablation margin—(a partially discontinuous ablation margin with protrusion of HCC), and indeterminate (index tumor was not visible). The minimal ablation margin was measured, and clinical factors were examined to identify other risk factors for LTP.

Results

LTP was observed at follow-up in 12 tumors. The mean minimal ablation margin was 3.6 mm. Multivariate analysis revealed that the ablation margin status was the only significant factor (p = 0.028). The cumulative LTP rates (3.3%, 3.3%, and 3.3% at 1, 2, and 3 years, respectively) in 30 ablation margin + nodules were significantly lower (p = 0.006) than those (20.0%, 28.0%, and 32.2% at 1, 2, and 3 years, respectively) in 25 ablation margin-zero nodules.

Conclusions

Fusion images enable an early assessment of the ablation efficacy in the majority of HCCs. The ablation margin status is a significant factor for LTP.

Keywords

Fusion RFA EOB-MRI Hepatocellular carcinoma Hepatobiliary phase 

Notes

Compliance with ethical standards

Funding

No funding was received for this study.

Conflict of interest

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

The Institutional Review Board waived the requirement for informed consent for this retrospective study.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Nobuyuki Takeyama
    • 1
    Email author
  • Naruki Mizobuchi
    • 2
  • Masashi Sakaki
    • 3
  • Yu Shimozuma
    • 3
  • Jiro Munechika
    • 2
  • Atsushi Kajiwara
    • 3
  • Manabu Uchikoshi
    • 3
  • Syojiro Uozumi
    • 3
  • Yoshimitsu Ohgiya
    • 2
  • Takehiko Gokan
    • 2
  1. 1.Department of RadiologyShowa University Fujigaoka HospitalYokohama-CityJapan
  2. 2.Department of RadiologyShowa University School of MedicineTokyoJapan
  3. 3.Department of GastroenterologyShowa University School of MedicineTokyoJapan

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