Assessment of ablative margin by unenhanced magnetic resonance imaging after radiofrequency ablation for hepatocellular carcinoma

Koda, Masahiko; Tokunaga, Shiho; Miyoshi, Kennichi; Kishina, Manabu; Fujise, Yuki; Kato, Jun; Matono, Tomomitsu; Okamoto, Kinya; Murawaki, Yoshikazu; Kakite, Suguru

doi:10.1016/j.ejrad.2011.11.013

Cited by 35 publications

(29 citation statements)

References 15 publications

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“…Local tumor progression was defined as the appearance of enhancement around the ablated tumor. Regarding unenhanced MRI, a high signal intensity area on the T1 weighted image was considered an ablative zone, according to a previous study in the liver (22). The treatment was considered to be successful when the targeted lesion was covered by the hyperintense area.…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes of percutaneous radiofrequency ablation for small renal cancer

et al. 2017

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Abstract. Partial nephrectomy is the treatment of choice for small renal cell carcinoma (RCC) from the perspective of cancer management and renal function. However, when patients with RCC are of advanced age, exhibit severe comorbidities, including cardiovascular and pulmonary diseases, or have hereditary RCC, ablative therapies, including radiofrequency ablation (RFA) and cryoablation are useful treatment options. In the present study, the clinical outcomes of percutaneous RFA for treating small RCC were evaluated. Between December 2005 and March 2015, 40 patients (41 renal tumors in total) underwent RFA and a total of 50 sessions of RFA were performed. The average tumor size was 2.5 cm. A total of 18 tumors were exophytic and 23 were parenchymal. Of the 41 tumors, 85.4% were completely ablated by initial RFA and the rate of complete ablation following reablation for residual viable lesions was 95.1%. Local recurrence-free survival following complete ablation was 84.2% at 3 years. A patient with a 4.7 cm RCC tumor rapidly progressed following four RFA treatments until complete ablation was achieved. The metastasis-free survival rate following initial RFA was 95.7% at 3 years. The RCC-specific survival was 100% (mean follow-up, 38 months). Adverse events occurred in five sessions (10%); however, only 1 patient with arteriovenous fistula required intervention (transarterial embolization). The mean hospital stay following RFA was 3.2 days. The mean decrease in estimated glomerular filtration rate following RFA was 2.7%. The results of the present study indicate that percutaneous RFA was an effective treatment for small RCCs with respect to management of cancer, minimal invasiveness and minimal loss of renal function, particularly in patients for whom surgery would be a high risk and those at increased risk of deterioration of renal function.

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Section: Introductionmentioning

confidence: 99%

Clinical outcomes of percutaneous radiofrequency ablation for small renal cancer

et al. 2017

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“…Several studies (20,21) found that the LTP rate tends to be lower in HCC patients with an adequate ablation margin, it has to be considered that LTP mainly occurs in the periphery of the ablation zone which is often not completely included in the ROI, being drawn along the macroscopically visible contours of the ablation zone, thus it is very important to analyze the periphery of the ablation zone separately.…”

Section: Discussionmentioning

confidence: 99%

Added value of diffusion weighted MRI in evaluation of treatment response: post radiofrequency ablation for hepatocellular carcinoma

Nassef

2015

The Egyptian Journal of Radiology and Nuclear Medicine

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Objective: To evaluate the feasibility of DWI and the corresponding ADC values to detect local tumor progression (LTP) after radiofrequency ablation for hepatocellular carcinoma. Materials and methods: 139 MR examinations were done for 51 HCC patients post-RFA. Pre and postgadolinium enhanced images as well as DW sequences were performed. ADC values of ablation zones and liver parenchyma were assessed. ADC values of ablation zones and adjacent signal alterations identified in DWI were analyzed. Results: LTP was detected in 12 patients (23.5%) and 16 lesions (21.9%). The mean ADC value of ablated zones differed significantly from that of normal liver parenchyma. No obvious changes were detected in the ADC values of the ablated zones over time. ROIs covering the whole ablation zone showed no significant ADC value difference regarding the presence or absence of LTP. DWI showed 53 hyperintense areas in the periphery of the ablated zones, and the corresponding ADC values were significantly lower in patients with LTP than in patients without LTP. Conclusion: DWI is a feasible follow-up tool for postablation liver contributing in detection of LTP. ADC based evaluation of signal alterations in the periphery of the ablation zone may be helpful in differentiation between LTP and post treatment tissue changes.

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“…It is also preferable for the patients to refrain from exposure to radiation. MRI has also been used for evaluating the therapeutic effect of RFA [27,28]. However, patients who have a heart pacemaker, a metallic foreign body (metal sliver) in the eye or an aneurysm clip in the brain, cannot have an MRI scan because the magnetic field may dislodge the metal.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of Contrast-Enhanced Ultrasonography to Evaluate the Post-Treatment Responses of Radiofrequency Ablation for Hepatocellular Carcinoma: Comparison with Dynamic CT

et al. 2013

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Objective: Contrast-enhanced ultrasonography (CEUS) with Sonazoid® and dynamic computed tomography (CT) were used to evaluate radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC). Local recurrence rate was used as the gold standard of evaluation. Methods: From January 2007 to December 2011, 86 HCCs from 70 patients were treated with RFA. CEUS with Sonazoid and dynamic CT were then used to evaluate the effect of RFA. For CEUS and dynamic CT, effects were classified as follows: (1) complete ablated response with safety margin >5 mm (CRSM+); (2) complete ablated response but with safety margin <5 mm (CRSM-); (3) incomplete, residual tumor detected after treatment. Results: CEUS judged 33 cases as CRSM+, while dynamic CT identified 49 cases. None of these 33 cases from the CEUS group had local recurrences, while dynamic CT had 1 case. CEUS judged 49 cases as CRSM-, compared to 34 cases with dynamic CT. Of these, 9 cases of CEUS and 8 cases of dynamic CT showed local recurrences. Two cases diagnosed as ‘incomplete' by CEUS and dynamic CT had recurrences within 1 year. Conclusion: CEUS can be used to assess the efficacy of RFA for HCC, with the potential to reduce the number of CT scans required for confirmation.

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Assessment of ablative margin by unenhanced magnetic resonance imaging after radiofrequency ablation for hepatocellular carcinoma

Cited by 35 publications

References 15 publications

Clinical outcomes of percutaneous radiofrequency ablation for small renal cancer

Clinical outcomes of percutaneous radiofrequency ablation for small renal cancer

Added value of diffusion weighted MRI in evaluation of treatment response: post radiofrequency ablation for hepatocellular carcinoma

Usefulness of Contrast-Enhanced Ultrasonography to Evaluate the Post-Treatment Responses of Radiofrequency Ablation for Hepatocellular Carcinoma: Comparison with Dynamic CT

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