Breath-hold PET/CT-guided tumour ablation under general anaesthesia: accuracy of tumour image registration and projected ablation zone overlap

Shyn, Paul B.; Tremblay-Paquet, Sophie; Palmer, Keryn; Tatlı, Servet; Tuncalı, Kemal; Olubiyi, Olutayo I.; Hata, Nobuhiko; Silverman, Stuart G.

doi:10.1016/j.crad.2016.10.017

Cited by 10 publications

(6 citation statements)

References 22 publications

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“…The previously described perfusion PET technique and the PET/CT technique described in the current study both provide a direct depiction of the tumor ablation margin without using retrospective images. PET/CT image registration is optimized by obtaining both PET and CT acquisitions during a single breath-hold [17,28]. Neither method requires an intraprocedural FDG uptake period for the tracer to localize in post-ablation residual tumor.…”

Section: Discussionmentioning

confidence: 99%

“…Intraprocedural, single-bed position PET/CT scans were obtained as needed for targeting and assessment of ablation results. Both PET and CT acquisitions were obtained during a single < 80-s breath-hold (ventilator pause in expiration) to optimize PET/CT image co-registration [17]. The PET acquisition time was 60 s. When available, postprocedural MRI or CT scans within 30 days after ablation were compared with PET/CT as described below.…”

Section: Imaging Protocolsmentioning

confidence: 99%

“…Forty-five of 77 (58%) tumors in 33 of 60 (55%) procedures were treated using MWA with either a 14-or 16-G applicator (Amica; HS Medical, Boca Raton, Fla); thirty-two of 77 (42%) tumors in 27 of 60 (45%) procedures were treated using cryoablation with an average of 3.4 (range 1-9) 14-G or 17-G cryoprobes per tumor (Cryo-Hit; Galil Medical, Arden Hills, MN). Ablation protocols followed previously published methods [16,17,19].…”

Section: Pet/ct-guided Ablation and Outcomesmentioning

confidence: 99%

“…These PET/CT images can depict the final anatomy of the tumor, the ablation zone, and the resulting ablation margin ( Fig. 1) [17].…”

Section: Introductionmentioning

confidence: 99%

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Assessing ablation margins of FDG-avid liver tumors during PET/CT-guided thermal ablation procedures: a retrospective study

Casadaban

Catalano

Lee

et al. 2021

Eur J Nucl Med Mol Imaging

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Background To retrospectively assess liver tumor ablation margins using intraprocedural PET/CT images from FDG PET/CTguided microwave or cryoablation procedures and to correlate minimum margin measurements with local progression outcomes. Methods Fifty-six patients (ages 36 to 85, median 62; 32 females) with 77 FDG-avid liver tumors underwent 60 FDG PET/CT guided, percutaneous microwave, or cryoablation procedures. Single breath-hold PET/CT images were used for intraprocedural assessment of the tumor ablation margin: liver tumors remained visible on PET immediately following ablation; microwave ablation zones were visible using contrast-enhanced CT; cryoablation zones (ice balls) were visible using unenhanced CT. Two readers retrospectively determined ablation margin assessability and measured the minimum ablation margin on intraprocedural PET/CT (n = 77) and postprocedural MRI (n = 56). Local tumor progression was assessed on all available follow-up imaging (1-49 months, mean 15). Local tumor progression was correlated with PET/CT minimum margin measurements using clustered survival models for 61 tumors. Results Minimum ablation margins were more often assessable using intraprocedural PET/CT (≥ 73/77 tumors, 95%) than postprocedural MRI (≤ 35/56 tumors, 63%). In 61 tumors with PET/CT-assessable margins (excluding tumors with overlapping ablations after PET/CT), there was a 6-fold increased risk of local tumor progression [hazard ratio (HR) 6.05; P = 0.004] for minimum ablation margins < 5 mm. Conclusion Breath-hold PET/CT scans, during PET/CT-guided microwave or cryoablation procedures for FDG-avid liver tumors, enable reliable intraprocedural assessment of the entire tumor ablation margin; a minimum PET/CT ablation margin threshold of 5 mm correlates well with local tumor progression outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Imaging Protocolsmentioning

confidence: 99%

Section: Pet/ct-guided Ablation and Outcomesmentioning

confidence: 99%

“…These PET/CT images can depict the final anatomy of the tumor, the ablation zone, and the resulting ablation margin ( Fig. 1) [17].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Assessing ablation margins of FDG-avid liver tumors during PET/CT-guided thermal ablation procedures: a retrospective study

Casadaban

Catalano

Lee

et al. 2021

Eur J Nucl Med Mol Imaging

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“…Registering the pre- and post-ablation images has been a promising alternative to conventional side-by-side assessment for AMs, which has many advantages as follows ( 21 – 23 ): (1) faster and more accurate measurement of safety boundaries and (2) clearer observation of the spatial relationship between the tumor and ablation zone. Therefore, an increasing number of registration methods have emerged for evaluating AMs.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Ablative Margin After Microwave Ablation for Hepatocellular Carcinoma Using Deep Learning-Based Deformable Image Registration

Jiang

Huang

et al. 2020

Front. Oncol.

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Aim: To assess the ablative margin (AM) after microwave ablation (MWA) for hepatocellular carcinoma (HCC) with a deep learning-based deformable image registration (DIR) technique and analyze the relation between the AM and local tumor progression (LTP). Patients and Methods: From November 2012 to April 2019, 141 consecutive patients with single HCC (diameter ≤ 5 cm) who underwent MWA were reviewed. Baseline characteristics were collected to identify the risk factors for the determination of LTP after MWA. Contrast-enhanced magnetic resonance imaging scans were performed within 1 month before and 3 months after treatment. Complete ablation was confirmed for all lesions. The AM was measured based on the margin size between the tumor region and the deformed ablative region. To correct the misalignment, DIR between images before and after ablation was achieved by an unsupervised landmark-constrained convolutional neural network. The patients were classified into two groups according to their AMs: group A (AM ≤ 5 mm) and group B (AM > 5 mm). The cumulative LTP rates were compared between the two groups using Kaplan-Meier curves and the log-rank test. Multivariate analyses were performed on clinicopathological variables to identify factors affecting LTP. Results: After a median follow-up period of 28.9 months, LTP was found in 19 patients. The mean tumor and ablation zone sizes were 2.3 ± 0.9 cm and 3.8 ± 1.2 cm, respectively. The mean minimum ablation margin was 3.4 ± 0.7 mm (range, 0-16 mm). The DIR technique had higher AUC for 2-year LTP without a significant difference compared with the registration assessment without DL (P = 0.325). The 6-, 12-, and 24month LTP rates were 9.9, 20.6, and 24.8%, respectively, in group A, and 4.0, 8.4, and 8.4%, respectively, in group B. There were significant differences between the two groups (P = 0.011). Multivariate analysis showed that being >65 years of age (P = 0.032, hazard ratio (HR): 2.463, 95% confidence interval (CI), 1.028-6.152) and AM ≤ 5 mm (P = 0.010, HR: 3.195, 95% CI, 1.324-7.752) were independent risk factors for LTP after MWA. An et al. Using Deep Learning for Registration Conclusion: The novel technology of unsupervised landmark-constrained convolutional neural network-based DIR is feasible and useful in evaluating the ablative effect of MWA for HCC.

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Liver tumor F-18 FDG-PET before and immediately after microwave ablation enables imaging and quantification of tumor tissue contraction

Yan

Khorasani

Levesque

et al. 2020

Eur J Nucl Med Mol Imaging

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Breath-hold PET/CT-guided tumour ablation under general anaesthesia: accuracy of tumour image registration and projected ablation zone overlap

Cited by 10 publications

References 22 publications

Assessing ablation margins of FDG-avid liver tumors during PET/CT-guided thermal ablation procedures: a retrospective study

Assessing ablation margins of FDG-avid liver tumors during PET/CT-guided thermal ablation procedures: a retrospective study

Assessment of Ablative Margin After Microwave Ablation for Hepatocellular Carcinoma Using Deep Learning-Based Deformable Image Registration

Liver tumor F-18 FDG-PET before and immediately after microwave ablation enables imaging and quantification of tumor tissue contraction

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