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Prediction of local tumor progression after radiofrequency ablation of hepatocellular carcinoma: retrospective registration of pre- and post-ablation imaging

Hendriks, Pim (2018) Prediction of local tumor progression after radiofrequency ablation of hepatocellular carcinoma: retrospective registration of pre- and post-ablation imaging.

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Abstract:Background: Radiofrequency ablation (RFA) is an established first line treatment for very early-stage HCC, and is used for unresectable early stage HCC. Post-ablation contrast-enhanced computed tomography (CECT) with qualitative ablation margin assessment is often used to determine technical success. Local tumor progression (LTP) rate of RFA for early-stage HCC is higher than after surgery. The objective of this study is to retrospectively use quantitative RFA margin assessment with use of non-rigid CT-CT co-registration, to assess whether there is a correlation of LTP and narrow margins. Methods: Twenty-five patients that were treated with RFA for HCC between 2009 and 2014 were retrospectively included. Semi-automated co-registration of pre- and post-treatment CECT was done independently by two radiologists, using RTx Mirada Software. The tumor and ablation area were delineated, to identify the side and size of narrowest RFA margin. The outcome of the margin assessments was compared with the occurrence of LTP, and inter-observer agreement was determined. Results: The scans of 18/25 patients were technically feasible for CT-CT co-registration. Almost perfect inter-observer agreement was found for quantitative analysis with a κ of 0.88 (SE: 0.116 and p <0.001). The tumors of 12/18 patients were not fully ablated. LTP occurred in 8 (75.0%) of these patients. In 6/18 patients, the RFA area fully encompassed the tumor. None of these patients developed LTP. Conclusion: Quantitative RFA margin assessment using non-rigid CT-CT co-registration is predictive for LTP in HCC patients.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:44 medicine
Programme:Technical Medicine MSc (60033)
Link to this item:http://purl.utwente.nl/essays/75050
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