Author:
Bressem Keno K.,Vahldiek Janis L.,Erxleben Christoph,Shnayien Seyd,Poch Franz,Geyer Beatrice,Lehmann Kai S.,Hamm B.,Niehues Stefan M.
Abstract
AbstractAfter hepatic microwave ablation, the differentiation between fully necrotic and persistent vital tissue through contrast enhanced CT remains a clinical challenge. Therefore, there is a need to evaluate new imaging modalities, such as CT perfusion (CTP) to improve the visualization of coagulation necrosis. MWA and CTP were prospectively performed in five healthy pigs. After the procedure, the pigs were euthanized, and the livers explanted. Orthogonal histological slices of the ablations were stained with a vital stain, digitalized and the necrotic core was segmented. CTP maps were calculated using a dual-input deconvolution algorithm. The segmented necrotic zones were overlaid on the DICOM images to calculate the accuracy of depiction by CECT/CTP compared to the histological reference standard. A receiver operating characteristic analysis was performed to determine the agreement/true positive rate and disagreement/false discovery rate between CECT/CTP and histology. Standard CECT showed a true positive rate of 81% and a false discovery rate of 52% for display of the coagulation necrosis. Using CTP, delineation of the coagulation necrosis could be improved significantly through the display of hepatic blood volume and hepatic arterial blood flow (p < 0.001). The ratios of true positive rate/false discovery rate were 89%/25% and 90%/50% respectively. Other parameter maps showed an inferior performance compared to CECT.
Funder
Deutsche Forschungsgemeinschaft
Publisher
Springer Science and Business Media LLC
Reference39 articles.
1. Simon, C. J., Dupuy, D. E. & Mayo-Smith, W. W. Microwave Ablation: Principles and Applications. RadioGraphics 25, S69–S83 (2005).
2. Martin, R. C. G., Scoggins, C. R. & McMasters, K. M. Safety and Efficacy of Microwave Ablation of Hepatic Tumors: A Prospective Review of a 5-Year Experience. Annals of Surgical Oncology 17, 171–178 (2010).
3. Moon, S. et al. Comparison of elastography, contrast-enhanced ultrasonography, and computed tomography for assessment of lesion margin after radiofrequency ablation in livers of healthy dogs. American Journal of Veterinary Research 78, 295–304 (2017).
4. Lu, M.-d et al. Comparison of Contrast Enhanced Ultrasound and Contrast Enhanced CT or MRI in Monitoring Percutaneous Thermal Ablation Procedure in Patients with Hepatocellular Carcinoma: A Multi-Center Study in China. Ultrasound in Medicine &. Biology 33, 1736–1749 (2007).
5. Wile, G. E., Leyendecker, J. R., Krehbiel, K. A., Dyer, R. B. & Zagoria, R. J. CT and MR Imaging after Imaging-guided Thermal Ablation of Renal Neoplasms. RadioGraphics 27, 325–339 (2007).
Cited by
7 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献