Feng Pan1,2, Thuy D Do1, Dominik F Vollherbst1,3, Philippe L Pereira4, Götz M Richter5, Michael Faerber1, Karl H Weiss6, Arianeb Mehrabi7, Hans U Kauczor1, Christof M Sommer1,5. 1. Clinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, 69120 Heidelberg, Germany. 2. Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China. 3. Department of Neuroradiology, University Hospital Heidelberg, 69120 Heidelberg, Germany. 4. Clinic for Radiology, Minimally-Invasive Therapies and Nuclear Medicine, SLK Kliniken Heilbronn GmbH, 74078 Heilbronn, Germany. 5. Clinic for Diagnostic and Interventional Radiology, Stuttgart Clinics, Katharinenhospital, 70174 Stuttgart, Germany. 6. Department of Gastroenterology, University of Heidelberg, 69117 Heidelberg, Germany. 7. Department of General, Visceral and Transplantation Surgery, University of Heidelberg, 69117 Heidelberg, Germany.
Abstract
INTRODUCTION: To explore the feasibility, safety, and efficiency of ethiodized oil tumor marking combined with irreversible electroporation (IRE) for small hepatocellular carcinomas (HCCs) that were invisible on unenhanced computed tomography (CT). METHODS: A retrospective analysis of the institutional database was performed from January 2018 to September 2018. Patients undergoing ethiodized oil tumor marking to improve target-HCC visualization in subsequent CT-guided IRE were retrieved. Target-HCC visualization after marking was assessed, and the signal-to-noise ratios (SNRs) and contrast-to-noise ratios (CNR) were compared between pre-marking and post-marking CT images using the paired t-test. Standard IRE reports, adverse events, therapeutic endpoints, and survival were summarized and assessed. RESULTS: Nine patients with 11 target-HCCs (11.1-18.8 mm) were included. After marking, all target-HCCs demonstrated complete visualization in post-marking CT, which were invisible in pre-marking CT. Quantitatively, the SNR of the target-HCCs significantly increased after marking (11.07 ± 4.23 vs. 3.36 ± 1.79, p = 0.006), as did the CNR (4.32 ± 3.31 vs. 0.43 ± 0.28, p = 0.023). In sequential IRE procedures, the average current was 30.1 ± 5.3 A, and both the delta ampere and percentage were positive with the mean values of 5.8 ± 2.1 A and 23.8 ± 6.3%, respectively. All procedures were technically successful without any adverse events. In the follow-up, no residual unablated tumor (endpoint-1) was observed. The half-year, one-year, and two-year local tumor progression (endpoint-2) rate was 0%, 9.1%, and 27.3%. The two-year overall survival rate was 100%. CONCLUSIONS: Ethiodized oil tumor marking enables to demarcate small HCCs that were invisible on unenhanced CT. It potentially allows a safe and complete ablation in subsequent CT-guided IRE.
INTRODUCTION: To explore the feasibility, safety, and efficiency of ethiodized oiltumor marking combined with irreversible electroporation (IRE) for small hepatocellular carcinomas (HCCs) that were invisible on unenhanced computed tomography (CT). METHODS: A retrospective analysis of the institutional database was performed from January 2018 to September 2018. Patients undergoing ethiodized oiltumor marking to improve target-HCC visualization in subsequent CT-guided IRE were retrieved. Target-HCC visualization after marking was assessed, and the signal-to-noise ratios (SNRs) and contrast-to-noise ratios (CNR) were compared between pre-marking and post-marking CT images using the paired t-test. Standard IRE reports, adverse events, therapeutic endpoints, and survival were summarized and assessed. RESULTS: Nine patients with 11 target-HCCs (11.1-18.8 mm) were included. After marking, all target-HCCs demonstrated complete visualization in post-marking CT, which were invisible in pre-marking CT. Quantitatively, the SNR of the target-HCCs significantly increased after marking (11.07 ± 4.23 vs. 3.36 ± 1.79, p = 0.006), as did the CNR (4.32 ± 3.31 vs. 0.43 ± 0.28, p = 0.023). In sequential IRE procedures, the average current was 30.1 ± 5.3 A, and both the delta ampere and percentage were positive with the mean values of 5.8 ± 2.1 A and 23.8 ± 6.3%, respectively. All procedures were technically successful without any adverse events. In the follow-up, no residual unablated tumor (endpoint-1) was observed. The half-year, one-year, and two-year local tumor progression (endpoint-2) rate was 0%, 9.1%, and 27.3%. The two-year overall survival rate was 100%. CONCLUSIONS:Ethiodized oiltumor marking enables to demarcate small HCCs that were invisible on unenhanced CT. It potentially allows a safe and complete ablation in subsequent CT-guided IRE.
Authors: Omid Khalilzadeh; Mark O Baerlocher; Paul B Shyn; Bairbre L Connolly; A Michael Devane; Christopher S Morris; Alan M Cohen; Mehran Midia; Raymond H Thornton; Kathleen Gross; Drew M Caplin; Gunjan Aeron; Sanjay Misra; Nilesh H Patel; T Gregory Walker; Gloria Martinez-Salazar; James E Silberzweig; Boris Nikolic Journal: J Vasc Interv Radiol Date: 2017-07-27 Impact factor: 3.464
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Authors: An Tang; Mustafa R Bashir; Michael T Corwin; Irene Cruite; Christoph F Dietrich; Richard K G Do; Eric C Ehman; Kathryn J Fowler; Hero K Hussain; Reena C Jha; Adib R Karam; Adrija Mamidipalli; Robert M Marks; Donald G Mitchell; Tara A Morgan; Michael A Ohliger; Amol Shah; Kim-Nhien Vu; Claude B Sirlin Journal: Radiology Date: 2017-11-21 Impact factor: 11.105
Authors: Johann J Wendler; Katharina Fischbach; Jens Ricke; Julian Jürgens; Frank Fischbach; Jens Köllermann; Markus Porsch; Daniel Baumunk; Martin Schostak; Uwe-Bernd Liehr; Maciej Pech Journal: Pol J Radiol Date: 2016-02-17