Volumetric 3D assessment of ablation zones after thermal ablation of colorectal liver metastases to improve prediction of local tumor progression Journal Article


Authors: Kaye, E. A.; Cornelis, F. H.; Petre, E. N.; Tyagi, N.; Shady, W.; Shi, W.; Zhang, Z.; Solomon, S. B.; Sofocleous, C. T.; Durack, J. C.
Article Title: Volumetric 3D assessment of ablation zones after thermal ablation of colorectal liver metastases to improve prediction of local tumor progression
Abstract: Purpose: The goal of this study was to develop and evaluate a volumetric three-dimensional (3D) approach to improve the accuracy of ablation margin assessment following thermal ablation of hepatic tumors. Methods: The 3D margin assessment technique was developed to generate the new 3D assessment metrics: volumes of insufficient coverage (VICs) measuring volume of tissue at risk post-ablation. VICs were computed for the tumor and tumor plus theoretical 5- and 10-mm margins. The diagnostic accuracy of the 3D assessment to predict 2-year local tumor progression (LTP) was compared to that of manual 2D assessment using retrospective analysis of a patient cohort that has previously been reported as a part of an outcome-centered study. Eighty-six consecutive patients with 108 colorectal cancer liver metastases treated with radiofrequency ablation (2002–2012) were used for evaluation. The 2-year LTP discrimination power was assessed using receiver operating characteristic area under the curve (AUC) analysis. Results: A 3D assessment of margins was successfully completed for 93 out of 108 tumors. The minimum margin size measured using the 3D method had higher discrimination power compared with the 2D method, with an AUC value of 0.893 vs. 0.790 (p = 0.01). The new 5-mm VIC metric had the highest 2-year LTP discrimination power with an AUC value of 0.923 (p = 0.004). Conclusions: Volumetric semi-automated 3D assessment of the ablation zone in the liver is feasible and can improve accuracy of 2-year LTP prediction following thermal ablation of hepatic tumors. Key Points: • More accurate prediction of local tumor progression risk using volumetric 3D ablation zone assessment can help improve the efficacy of image-guided percutaneous thermal ablation of hepatic tumors. • The accuracy of evaluation of ablation zone margins after thermal ablation of colorectal liver metastases can be improved using a volumetric 3D semi-automated assessment approach and the volume of insufficient coverage assessment metric. • The new 5-mm volume-of-insufficient-coverage metric, indicating the volume of tumor plus 5-mm margin that remained untreated, had the highest 2-year local tumor progression discrimination power. © 2018, European Society of Radiology.
Keywords: adult; controlled study; aged; major clinical study; area under the curve; cancer risk; comparative study; cancer staging; nuclear magnetic resonance imaging; outcome assessment; positron emission tomography; cancer diagnosis; diagnostic accuracy; computer assisted tomography; cohort analysis; retrospective study; three dimensional imaging; liver tumor; neoplasm metastasis; tumor growth; image processing, computer-assisted; radiofrequency ablation; receiver operating characteristic; volumetry; minimally invasive surgical procedures; colorectal liver metastasis; human; male; female; priority journal; article
Journal Title: European Radiology
Volume: 29
Issue: 5
ISSN: 0938-7994
Publisher: Springer  
Date Published: 2019-05-01
Start Page: 2698
End Page: 2705
Language: English
DOI: 10.1007/s00330-018-5809-0
PUBMED: 30402706
PROVIDER: scopus
PMCID: PMC6719337
DOI/URL:
Notes: Article -- Export Date: 1 May 2019 -- Source: Scopus
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Citation Impact
MSK Authors
  1. Zhigang Zhang
    273 Zhang
  2. Weiji Shi
    121 Shi
  3. Stephen Solomon
    302 Solomon
  4. Elena Nadia Petre
    58 Petre
  5. Jeremy Charles Durack
    94 Durack
  6. Neelam Tyagi
    75 Tyagi
  7. Elena Aleksandrovna Kaye
    7 Kaye
  8. Waleed   Shady
    10 Shady