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Radiology. 2018 Jul;288(1):138-145. doi: 10.1148/radiol.2018172108. Epub 2018 Apr 3.

Intraprocedural Ablation Margin Assessment by Using Ammonia Perfusion PET during FDG PET/CT-guided Liver Tumor Ablation: A Pilot Study.

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From the Department of Radiology, Division of Abdominal Imaging and Intervention (P.B.S., L.C.C., N.I.S., C.A.S., P.M.B., V.M.L., S.G.S.) and Division of Nuclear Medicine (C.K.K., V.H.G.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115.


Purpose To prospectively determine whether nitrogen 13 (13N) ammonia perfusion positron emission tomography (PET) during fluorine 18 fluorodeoxyglucose (FDG) PET/computed tomography (CT)-guided liver tumor ablation can be used to intraprocedurally assess ablation margins. Materials and Methods Eight patients (five women and three men; age range, 36-74 years; mean age, 57 years) were enrolled in this pilot study and underwent FDG PET/CT-guided microwave ablation of 11 FDG-avid liver metastases (mean diameter, 22 mm; range, 11-34 mm). All procedures were performed between March 2014 and December 2016. Complete ablation margin visibility and minimum ablation margin thickness were assessed by using intraprocedural 13N-ammonia perfusion PET compared with 24-hour postprocedural MR imaging by two independent blinded radiologists. Local tumor progression for each ablated tumor was assessed at follow-up imaging for 3-38 months (median, 17.6 months). Descriptive analysis was performed. Results Eleven of 11 (100%) ablation margins were fully assessable by using intraprocedural perfusion PET by both readers; six of eleven (55%) margins were fully assessable by both readers at postprocedural 24-hour MR imaging. By using perfusion PET, one tumor that had been judged by both readers to have a minimum margin of 0 mm progressed locally. No tumors judged to have a minimum margin greater than 0 mm at perfusion PET progressed locally. Conclusion 13N-ammonia perfusion PET during FDG PET/CT-guided liver tumor ablations can potentially be used to intraprocedurally assess the entire ablation margin, including the minimum margin. © RSNA, 2018.

[Indexed for MEDLINE]

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