Frederik Vandenbroucke1, Jef Vandemeulebroucke2, Bart Ilsen3, Douwe Verdries3, Dries Belsack3, Hendrik Everaert4, Nico Buls3, Pablo R Ros5, Johan de Mey3. 1. Department of Radiology, UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium. Electronic address: spovef@uzbrussel.be. 2. Department of Electronics and Informatics, Vrije Universiteit Brussel, Brussels, Belgium; Department of Future Media and Imaging, iMinds, Brussels, Belgium. 3. Department of Radiology, UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium. 4. Department of Nuclear Medicine, UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium. 5. Department of Radiology, University Hospitals Case Medical Center/Case Western Reserve University, Cleveland, Ohio.
Abstract
PURPOSE: To assess a classification scheme for predicting local tumor progression (LTP) after radiofrequency (RF) ablation of liver metastases, using predefined patterns on contrast-enhanced computed tomography (CT) and positron emission tomography (PET) combined with CT (PET/CT) acquired 24 hours after RF ablation. MATERIALS AND METHODS: There were 45 metastases in 20 patients treated. After 24 hours, imaging of the ablation zones was performed with contrast-enhanced PET/CT. Three independent radiologists prospectively assessed contrast-enhanced CT and combined PET/CT images to identify three patterns: pattern I, no tissue enhancement or fluorodeoxyglucose uptake between the ablation zone and the liver parenchyma; pattern II, a rimlike pattern; and pattern III, a peripheral nodule. PET/CT images obtained after 8-10 weeks were evaluated for LTP. The patterns were analyzed for their sensitivity, specificity, positive predictive value, and negative predictive value for predicting LTP. RESULTS: Pattern I was most frequently observed (81% for contrast-enhanced CT and 61% for PET/CT) as well as for ablation zones that showed LTP (52% and 37%, respectively). Conversely, pattern II was observed for tumors that were completely ablated (6% and 29%, respectively). Patterns II and III together had the highest sensitivity for predicting LTP (48% and 63%, respectively); pattern III had the highest specificity (94% and 95%, respectively). For nodular patterns, test characteristics were better for PET/CT compared with contrast-enhanced CT, but the difference was not significant. Nodular patterns > 1 cm achieved high positive predictive value (both 100%). CONCLUSIONS: Inflammation and hyperemia can hinder interpretation on imaging 24 hours after RF ablation, especially on PET/CT. Nodular patterns around the ablation zone on early contrast-enhanced CT and PET/CT have a high predictive value for LTP and should be taken into account for disease management.
PURPOSE: To assess a classification scheme for predicting local tumor progression (LTP) after radiofrequency (RF) ablation of liver metastases, using predefined patterns on contrast-enhanced computed tomography (CT) and positron emission tomography (PET) combined with CT (PET/CT) acquired 24 hours after RF ablation. MATERIALS AND METHODS: There were 45 metastases in 20 patients treated. After 24 hours, imaging of the ablation zones was performed with contrast-enhanced PET/CT. Three independent radiologists prospectively assessed contrast-enhanced CT and combined PET/CT images to identify three patterns: pattern I, no tissue enhancement or fluorodeoxyglucose uptake between the ablation zone and the liver parenchyma; pattern II, a rimlike pattern; and pattern III, a peripheral nodule. PET/CT images obtained after 8-10 weeks were evaluated for LTP. The patterns were analyzed for their sensitivity, specificity, positive predictive value, and negative predictive value for predicting LTP. RESULTS: Pattern I was most frequently observed (81% for contrast-enhanced CT and 61% for PET/CT) as well as for ablation zones that showed LTP (52% and 37%, respectively). Conversely, pattern II was observed for tumors that were completely ablated (6% and 29%, respectively). Patterns II and III together had the highest sensitivity for predicting LTP (48% and 63%, respectively); pattern III had the highest specificity (94% and 95%, respectively). For nodular patterns, test characteristics were better for PET/CT compared with contrast-enhanced CT, but the difference was not significant. Nodular patterns > 1 cm achieved high positive predictive value (both 100%). CONCLUSIONS: Inflammation and hyperemia can hinder interpretation on imaging 24 hours after RF ablation, especially on PET/CT. Nodular patterns around the ablation zone on early contrast-enhanced CT and PET/CT have a high predictive value for LTP and should be taken into account for disease management.
Authors: Francois Cornelis; Vlasios Sotirchos; Elena Violari; Constantinos T Sofocleous; Heiko Schoder; Jeremy C Durack; Robert H Siegelbaum; Majid Maybody; John Humm; Stephen B Solomon Journal: J Nucl Med Date: 2016-02-23 Impact factor: 10.057
Authors: Francois H Cornelis; Elena N Petre; Efsevia Vakiani; David Klimstra; Jeremy C Durack; Mithat Gonen; Joseph Osborne; Stephen B Solomon; Constantinos T Sofocleous Journal: J Nucl Med Date: 2018-02-09 Impact factor: 10.057
Authors: Frederik Vandenbroucke; Steven Van Hedent; Gert Van Gompel; Nico Buls; Gordon Craggs; Jef Vandemeulebroucke; Pablo R Ros; Johan de Mey Journal: Insights Imaging Date: 2015-05-05
Authors: Frederik Vandenbroucke; Jef Vandemeulebroucke; Nico Buls; Ruedi F Thoeni; Johan de Mey Journal: Int J Comput Assist Radiol Surg Date: 2018-04-12 Impact factor: 2.924