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Does hepatobiliary phase sequence qualitatively outperform unenhanced T1-weighted imaging in assessment of the ablation margin 24 hours after thermal ablation of hepatocellular carcinomas?

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Abstract

Purpose

To retrospectively determine whether hepatobiliary phase (HBP) sequence outperforms unenhanced T1-weighted imaging (uT1wI) in distinguishing the ablation margin (AM) from hepatocellular carcinoma (HCC) 24 h after thermoablation.

Material and methods

Ninety-one patients [mean age, 65.7 years; 68 M/23F] with 138 HCCs (>6 months follow-up) underwent pre- and postablation gadoxetate disodium-enhanced MRI. AM showed a hyperintense middle zone (MZ) surrounding central hypo- or hyperintense HCCs on uT1wI, and an intermediate-intense MZ encompassing central hypo- or hyperintense HCCs during HBP. The visible AM was defined as persistent MZ around HCCs, which were demarcated from MZ, or peripherally band encompassing MZ, which were not demarcated from HCC. The indefinite AM was defined as no demarcating HCCs from MZ. The ability to distinguish AM from HCC was classified as visible or indefinite on axial (ax)-uT1wI, ax-HBP, coronal (cor)-HBP, and combined all images. To investigate the AM visibility during HBP, significance of differences upon comparison of ax-uT1wI with combined images was analyzed. Preablation liver-tumor contrast ratio (LTCR) on ax-uT1wI and ax-HBP sequence is compared between the visible and indefinite AM.

Results

The McNemar test demonstrated a significant increase (p < 0.05) in visible AM from ax-uT1wI (60), to ax-HBP (70), cor-HBP (79), and combined images (83). TLCR with visible AM was significantly higher than that with indefinite AM on ax-uT1wI (0.4 vs. 0.2, p = 0.001) and ax-HBP sequence (0.9 vs. 0.6, p = 0.004).

Conclusions

HBP sequence might have higher feasibility to distinguish AM from tumor than ax-uT1wI. The TLCR value in visible AM was higher than that in indefinite AM on both ax-uT1wI and ax-HBP sequences.

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References

  1. Sainani NI, Gervais DA, Mueller PR, Arellano RS (2013) Imaging after percutaneous radiofrequency ablation of hepatic tumors: Part 1, normal findings. AJR Am J Roentgenol 200:184–193

    Article  PubMed  Google Scholar 

  2. Sainani NI, Gervais DA, Mueller PR, Arellano RS (2013) Imaging after percutaneous radiofrequency ablation of hepatic tumors: Part 2, abnormal findings. AJR Am J Roentgenol 200:194–204

    Article  PubMed  Google Scholar 

  3. Kierans AS, Elazzazi M, Braga L, et al. (2010) Thermoablative treatments for malignant liver lesions: 10-year experience of MRI appearances of treatment response. AJR Am J Roentgenol 194:523–529

    Article  PubMed  Google Scholar 

  4. Kei SK, Rhim H, Choi D, et al. (2008) Local tumor progression after radiofrequency ablation of liver tumors: analysis of morphologic pattern and site of recurrence. AJR Am J Roentgenol 190:1544–1551

    Article  PubMed  Google Scholar 

  5. Mulier S, Ni Y, Jamart J, et al. (2005) Local recurrence after hepatic radiofrequency coagulation: multivariate meta-analysis and review of contributing factors. Ann Surg 242:158–171

    Article  PubMed  PubMed Central  Google Scholar 

  6. Ng KK, Poon RT, Lo CM, et al. (2008) Analysis of recurrence pattern and its influence on survival outcome after radiofrequency ablation of hepatocellular carcinoma. Gastrointest Surg 12:183–191

    Article  Google Scholar 

  7. Goldberg SN, Gazelle GS, Mueller PR (2000) Thermal ablation therapy for focal malignancy: a unified approach to underlying principles, techniques, and diagnostic imaging guidance. AJR Am J Roentgenol 174:323–331

    Article  CAS  PubMed  Google Scholar 

  8. Kim YS, Rhim H, Lim HK, et al. (2001) Coagulation necrosis induced by radiofrequency ablation in the liver: histopathologic and radiologic review of usual to extremely rare changes. Radiographics 31:377–390

    Article  Google Scholar 

  9. Lee JD, Lee JM, Kim SW, Kim CS, Mun WS (2001) MR imaging-histopathological correlation of radiofrequency thermal ablation in a rabbit liver model: observation during acute and chronic stages. Korean J Radiol 2:151–158

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Onishi H, Matsushita M, Murakami T, et al. (2004) MR appearances of radiofrequency thermal ablation region: histopathologic correlation with dog liver models and an autopsy case. Acad Radiol 11:1180–1189

    Article  PubMed  Google Scholar 

  11. Hyodoh H, Furuse M, Kawamoto C, et al. (2000) Microwave coagulation therapy: ex vivo comparison of MR imaging and histopathology. J Magn Reson Imaging 11:168–173

    Article  CAS  PubMed  Google Scholar 

  12. Clasen S, Pereira PL (2008) Magnetic resonance guidance for radiofrequency ablation of liver tumors. J Magn Reson Imaging 27:421–433

    Article  PubMed  Google Scholar 

  13. Rempp H, Clasen S, Pereira PL (2012) Image-based monitoring of magnetic resonance-guided thermoablative therapies for liver tumors. Cardiovasc Interv Radiol 35:1281–1294

    Article  Google Scholar 

  14. Khankan A, Murakami T, Onishi H, et al. (2008) Hepatocellular carcinoma treated with radio frequency ablation: an early evaluation with magnetic resonance imaging. J Magn Reson Imaging 27:546–551

    Article  PubMed  Google Scholar 

  15. Koda M, Tokunaga S, Miyoshi K, et al. (2012) Assessment of ablative margin by unenhanced magnetic resonance imaging after radiofrequency ablation for hepatocellular carcinoma. Eur J Radiol 81:2730–2736

    Article  PubMed  Google Scholar 

  16. Yoon JH, Lee EJ, Cha SS, et al. (2010) Comparison of gadoxetic acid-enhanced MR imaging versus four-phase multi-detector row computed tomography in assessing tumor regression after radiofrequency ablation in subjects with hepatocellular carcinomas. J Vasc Interv Radiol 21:348–356

    Article  PubMed  Google Scholar 

  17. American College of Radiology website. (2014) Liver imaging reporting and data system. www.acr.org/ Quality-Safety/Resources/LIRADS. Accessed March 21.

  18. Mori K, Fukuda K, Asaoka H, et al. (2009) Radiofrequency ablation of the liver: determination of ablative margin at MR imaging with impaired clearance of ferucarbotran-feasibility study. Radiology 251:557–565

    Article  PubMed  Google Scholar 

  19. Ringe KI, Wacker F, Raatschen HJ (2015) Is there a need for MRI within 24 hours after CT-guided percutaneous thermoablation of the liver? Acta Radiol 56:10–17

    Article  PubMed  Google Scholar 

  20. Braga L, Semelka RC (2005) Magnetic resonance imaging features of focal liver lesions after intervention. Top Magn Reson Imaging 16:99–106

    Article  PubMed  Google Scholar 

  21. Ringe KI, Husarik DB, Sirlin CB, Merkle EM (2010) Gadoxetate disodium-enhanced MRI of the liver: Part 1, protocol optimization and lesion appearance in the noncirrhotic liver. AJR Am J Roentgenol 195:13–28

    Article  PubMed  Google Scholar 

  22. Clasen S, Boss A, Schmidt D, et al. (2006) Magnetic resonance imaging for hepatic radiofrequency ablation. Eur J Radiol 59:140–148

    Article  CAS  PubMed  Google Scholar 

  23. Zech CJ, Bartolozzi C, Bioulac-Sage P, et al. (2013) Consensus report of the fifth international forum for liver MRI. AJR Am J Roentgenol 201:97–107

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Showa University Fujigaoka Hospital, Yokohama, Japan

    Nobuyuki Takeyama

  2. Department of Radiology, David Geffen School of Medicine at UCLA, 757 Westwood Blvd, Los Angeles, CA, 90095, USA

    Nobuyuki Takeyama, Sirachat Vidhyarkorn, Dong Jin Chung, Surachate Siripongsakun, Hyun J. Kim, David S. K. Lu & Steven S. Raman

  3. Department of Radiology, Chalubhorn Hospital, Bangkok, Thailand

    Sirachat Vidhyarkorn & Surachate Siripongsakun

  4. Department of Radiology, Catholic University of Korea, Seoul, South Korea

    Dong Jin Chung

Authors
  1. Nobuyuki Takeyama
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  2. Sirachat Vidhyarkorn
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  3. Dong Jin Chung
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  4. Surachate Siripongsakun
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  5. Hyun J. Kim
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  6. David S. K. Lu
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  7. Steven S. Raman
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Correspondence to Nobuyuki Takeyama.

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Conflict of Interest

Nobuyuki Takeyama declares that he has no conflict of interest. Sirachat Vidhyarkorn declares that she has no conflict of interest. Dong Jin Chung declares that he has no conflict of interest. Surachate Siripongsakun declares that he has no conflict of interest. Author B declares that he has no conflict of interest. Hyun J. Kim declares that she has no conflict of interest. David S.K. Lu, declares that he has no conflict of interest. Steven S. Raman declares that he has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Takeyama, N., Vidhyarkorn, S., Chung, D.J. et al. Does hepatobiliary phase sequence qualitatively outperform unenhanced T1-weighted imaging in assessment of the ablation margin 24 hours after thermal ablation of hepatocellular carcinomas?. Abdom Radiol 41, 1942–1955 (2016). https://doi.org/10.1007/s00261-016-0796-6

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  • DOI: https://doi.org/10.1007/s00261-016-0796-6

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