3D margin assessment predicts local tumor progression after ablation of colorectal cancer liver metastases Journal Article
| Authors: | Vasiniotis Kamarinos, N.; Gonen, M.; Sotirchos, V.; Kaye, E.; Petre, E. N.; Solomon, S. B.; Erinjeri, J. P.; Ziv, E.; Kirov, A.; Sofocleous, C. T. |
| Article Title: | 3D margin assessment predicts local tumor progression after ablation of colorectal cancer liver metastases |
| Abstract: | Objective: To determine the feasibility and prognostic value of 3D measuring of the ablation margins using a dedicated image registration software. Methods: This retrospective study included 104 colorectal liver metastases in 68 consecutive patients that underwent microwave ablation between 08/2012 and 08/2019. The minimal ablation margin (MM) was measured in 2D using anatomic landmarks on contrast enhanced CT(CECT) 4–8 weeks post-ablation, and in 3D using an image registration software and immediate post-ablation CECT. Local tumor progression (LTP) was assessed by imaging up to 24 months after ablation. A blinded interventional radiologist provided feedback on the possibility of additional ablation after examining the 3D-margin measurements. Results: The 3D-margin assessment was completed in 79/104 (76%) tumors without the need for target manipulation. In 25/104 (24%) tumors, manipulation was required due to image misregistration. LTP was observed in 40/104 (38.5%) tumors: 92.5% vs 7.5% for those with margin <5mm vs ≥5mm, respectively (p = 0.0001). The 2D and 3D-assessments identified margin <5mm in 17/104 (16%), and in 74/104 (71%) ablated tumors, respectively (p < 0.01). The sensitivity and specificity of the 3D software for predicting LTP was 93% (37/40) and 42% (27/64), respectively. Additional ablation to achieve a MM of 5 mm would have been offered in 26/37 cases if the 3D-margin assessment was available intraoperatively. Conclusion: Image registration software can measure ablation margins and detect MM under 5 mm intraoperatively, with significantly higher sensitivity than the 2D technique using landmarks on the post-ablation CECT. The identification of a margin under 5 mm is strongly associated with LTP. © 2022 The Author(s). Published with license by Taylor & Francis Group, LLC. |
| Keywords: | treatment outcome; retrospective studies; liver neoplasms; tomography, x-ray computed; pathology; diagnostic imaging; retrospective study; colorectal neoplasms; colorectal tumor; liver tumor; catheter ablation; surgical margin; thermal ablation; procedures; humans; human; colorectal cancer liver metastases; x-ray computed tomography; margins of excision; ablation margin assessment |
| Journal Title: | International Journal of Hyperthermia |
| Volume: | 39 |
| Issue: | 1 |
| ISSN: | 0265-6736 |
| Publisher: | Taylor & Francis Group |
| Date Published: | 2022-01-01 |
| Start Page: | 880 |
| End Page: | 887 |
| Language: | English |
| DOI: | 10.1080/02656736.2022.2055795 |
| PUBMED: | 35848428 |
| PROVIDER: | scopus |
| PMCID: | PMC9442248 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 August 2022 -- Source: Scopus |
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
Related MSK Work