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Cardiovasc Intervent Radiol. 2017 Jun;40(6):873-883. doi: 10.1007/s00270-017-1571-y. Epub 2017 Jan 13.

Value of Nonrigid Registration of Pre-Procedure MR with Post-Procedure CT After Radiofrequency Ablation for Hepatocellular Carcinoma.

Author information

1
Department of Radiology, Seoul National University Hospital, Seoul, South Korea.
2
Department of Radiology, Seoul National University Hospital, Seoul, South Korea. jmlshy2000@gmail.com.
3
Department of Radiology, Institute of Radiation Medicine, Seoul National University College of Medicine, 101 Daehangno, Jongno-gu, Seoul, 03080, South Korea. jmlshy2000@gmail.com.
4
Department of Radiology, Dongnam Institute of Radiological and Medical Sciences, Busan, South Korea.
5
Siemens Healthineers, Computed Tomography, 91301, Forchheim, Germany.

Abstract

PURPOSE:

To evaluate the value of pre-radiofrequency ablation (RFA) MR and post-RFA CT registration for the assessment of the therapeutic response of hepatocellular carcinoma (HCC).

MATERIALS AND METHODS:

A total of 178 patients with single HCC who received RFA as an initial treatment and had available pre-RFA MR and post-RFA CT images were included in this retrospective study. Two independent readers (one experienced radiologist, one inexperienced radiologist) scored the ablative margin (AM) of treated tumors on a four-point scale (1, residual tumor; 2, incomplete AM; 3, borderline AM; 4, sufficient AM), in two separate sessions: (1) visual comparison between pre-and post-RFA images; (2) with addition of nonrigid registration for pre- and post-RFA images. Local tumor progression (LTP) rates between low-risk (response score, 3-4) and high-risk groups (1-2) were analyzed using the Kaplan-Meier method at each interpretation session.

RESULTS:

The patients' reassignments after using the registered images were statistically significant for inexperienced reader (p < 0.001). In the inexperienced reader, LTP rates of low- and high-risk groups were significantly different with addition of registered images (session 2) (p < 0.001), but not significantly different in session 1 (p = 0.101). However, in the experienced reader, LTP rates of low- and high-risk groups were significantly different in both interpretation sessions (p < 0.001). Using the registered images, the cumulative incidence of LTP at 2 years was 3.0-6.6%, for the low-risk group, and 18.6-27.8% for the high-risk group.

CONCLUSION:

Registration between pre-RFA MR and post-RFA CT images may allow better assessment of the therapeutic response of HCC after RFA, especially for inexperienced radiologists, helping in the risk stratification for LTP.

KEYWORDS:

Ablative margin; Hepatocellular carcinoma; Local tumor progression; Nonrigid registration; Radiofrequency ablation

PMID:
28091728
DOI:
10.1007/s00270-017-1571-y
[Indexed for MEDLINE]

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