Juil Park1, Jeong Min Lee2,3, Dong Ho Lee1, Ijin Joo1, Jeong Hee Yoon1, Jin Young Park4, Ernst Klotz5. 1. Department of Radiology, Seoul National University Hospital, Seoul, South Korea. 2. Department of Radiology, Seoul National University Hospital, Seoul, South Korea. jmlshy2000@gmail.com. 3. Department of Radiology, Institute of Radiation Medicine, Seoul National University College of Medicine, 101 Daehangno, Jongno-gu, Seoul, 03080, South Korea. jmlshy2000@gmail.com. 4. Department of Radiology, Dongnam Institute of Radiological and Medical Sciences, Busan, South Korea. 5. Siemens Healthineers, Computed Tomography, 91301, Forchheim, Germany.
Abstract
PURPOSE: To evaluate the value of pre-radiofrequency ablation (RFA) MR and post-RFA CT registration for the assessment of the therapeutic response of hepatocellular carcinoma (HCC). MATERIALS AND METHODS: A total of 178 patients with single HCC who received RFA as an initial treatment and had available pre-RFA MR and post-RFA CT images were included in this retrospective study. Two independent readers (one experienced radiologist, one inexperienced radiologist) scored the ablative margin (AM) of treated tumors on a four-point scale (1, residual tumor; 2, incomplete AM; 3, borderline AM; 4, sufficient AM), in two separate sessions: (1) visual comparison between pre-and post-RFA images; (2) with addition of nonrigid registration for pre- and post-RFA images. Local tumor progression (LTP) rates between low-risk (response score, 3-4) and high-risk groups (1-2) were analyzed using the Kaplan-Meier method at each interpretation session. RESULTS: The patients' reassignments after using the registered images were statistically significant for inexperienced reader (p < 0.001). In the inexperienced reader, LTP rates of low- and high-risk groups were significantly different with addition of registered images (session 2) (p < 0.001), but not significantly different in session 1 (p = 0.101). However, in the experienced reader, LTP rates of low- and high-risk groups were significantly different in both interpretation sessions (p < 0.001). Using the registered images, the cumulative incidence of LTP at 2 years was 3.0-6.6%, for the low-risk group, and 18.6-27.8% for the high-risk group. CONCLUSION: Registration between pre-RFA MR and post-RFA CT images may allow better assessment of the therapeutic response of HCC after RFA, especially for inexperienced radiologists, helping in the risk stratification for LTP.
PURPOSE: To evaluate the value of pre-radiofrequency ablation (RFA) MR and post-RFA CT registration for the assessment of the therapeutic response of hepatocellular carcinoma (HCC). MATERIALS AND METHODS: A total of 178 patients with single HCC who received RFA as an initial treatment and had available pre-RFA MR and post-RFA CT images were included in this retrospective study. Two independent readers (one experienced radiologist, one inexperienced radiologist) scored the ablative margin (AM) of treated tumors on a four-point scale (1, residual tumor; 2, incomplete AM; 3, borderline AM; 4, sufficient AM), in two separate sessions: (1) visual comparison between pre-and post-RFA images; (2) with addition of nonrigid registration for pre- and post-RFA images. Local tumor progression (LTP) rates between low-risk (response score, 3-4) and high-risk groups (1-2) were analyzed using the Kaplan-Meier method at each interpretation session. RESULTS: The patients' reassignments after using the registered images were statistically significant for inexperienced reader (p < 0.001). In the inexperienced reader, LTP rates of low- and high-risk groups were significantly different with addition of registered images (session 2) (p < 0.001), but not significantly different in session 1 (p = 0.101). However, in the experienced reader, LTP rates of low- and high-risk groups were significantly different in both interpretation sessions (p < 0.001). Using the registered images, the cumulative incidence of LTP at 2 years was 3.0-6.6%, for the low-risk group, and 18.6-27.8% for the high-risk group. CONCLUSION: Registration between pre-RFA MR and post-RFA CT images may allow better assessment of the therapeutic response of HCC after RFA, especially for inexperienced radiologists, helping in the risk stratification for LTP.
Authors: Timo T M Oosterveer; Gonnie C M van Erp; Pim Hendriks; Alexander Broersen; Christiaan G Overduin; Carla S P van Rijswijk; Arian R van Erkel; Rutger W van der Meer; Maarten E Tushuizen; Adriaan Moelker; Martijn R Meijerink; Otto M van Delden; Koert P de Jong; Christiaan van der Leij; Maarten L J Smits; Thijs A J Urlings; Jeffrey P B M Braak; Elma Meershoek-Klein Kranenbarg; Bianca van Duijn-de Vreugd; Evelijn Zeijdner; Jelle J Goeman; Jurgen J Fütterer; Minneke J Coenraad; Jouke Dijkstra; Mark C Burgmans Journal: Cardiovasc Intervent Radiol Date: 2022-03-01 Impact factor: 2.797
Authors: B G Sibinga Mulder; P Hendriks; T R Baetens; A R van Erkel; C S P van Rijswijk; R W van der Meer; C J H van de Velde; A L Vahrmeijer; J S D Mieog; M C Burgmans Journal: BMC Med Imaging Date: 2019-08-20 Impact factor: 1.930