Real-time split-dose PET/CT-guided ablation improves colorectal liver metastasis detection and ablation zone margin assessments without the need for repeated contrast injection Journal Article


Authors: Zirakchian Zadeh, M.; Yeh, R.; Kunin, H. S.; Kirov, A. S.; Petre, E. N.; Gönen, M.; Silk, M.; Cornelis, F. H.; Soares, K. C.; Ziv, E.; Solomon, S. B.; Sotirchos, V. S.; Sofocleous, C. T.
Article Title: Real-time split-dose PET/CT-guided ablation improves colorectal liver metastasis detection and ablation zone margin assessments without the need for repeated contrast injection
Abstract: Simple Summary: This study showed that adding PET to CT-guided ablation of CLMs can improve tumor detection for targeting, allowing for repeated tumor visualization for monitoring during ablation and assessing the ablation zone and margins after treatment completion while eliminating the need for repeated contrast administration before and during the ablation. Background: Real-time split-dose PET can identify the targeted colorectal liver metastasis (CLM) and eliminate the need for repeated contrast administration before and during thermal ablation (TA). This study aimed to assess the added value of pre-ablation real-time split-dose PET when combined with non-contract CT in the detection of CLM for ablation and the evaluation of the ablation zone and margins. Methods: A total of 190 CLMs/125 participants from two IRB-approved prospective clinical trials using PET/CT-guided TA were analyzed. Based on detection on pre-TA imaging, CLMs were categorized as detectable, non-detectable, and of poor conspicuity on CT alone, and detectable, non-detectable, and low FDG-avidity on PET/CT after the initial dose. Ablation margins around the targeted CLM were evaluated using a 3D volumetric approach. Results: We found that 129/190 (67.9%) CLMs were detectable on CT alone, and 61/190 CLMs (32.1%) were undetectable or of poor conspicuity, not allowing accurate depiction and targeting by CT alone. Thus, the theoretical 5- and 10-mm margins could not be defined in these tumors (32.1%) using CT alone. When TA intraprocedural PET/CT images are obtained and inspected (fused PET/CT), only 4 CLM (2.1%) remained undetectable or had a low FDG avidity. Conclusions: The addition of PET to non-contrast CT improved CLM detection for ablation targeting, margin assessments, and continuous depiction of the FDG avid CLMs during the ablation without the need for multiple intravenous contrast injections pre- and intra-procedurally.
Journal Title: Cancers
Volume: 14
Issue: 24
ISSN: 2072-6694
Publisher: MDPI  
Date Published: 2022-12-02
Start Page: 6253
Language: English
DOI: 10.3390/cancers14246253
PROVIDER: EBSCOhost
PROVIDER: cinahl
PMCID: PMC9777508
PUBMED: 36551738
DOI/URL:
Notes: Accession Number: 160958834 -- Entry Date: In Process -- Revision Date: 20221227 -- Publication Type: Article -- Journal Subset: Biomedical; Continental Europe; Europe -- NLM UID: 101526829. -- Source: Cinahl
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MSK Authors
  1. Mithat Gonen
    1033 Gonen
  2. Stephen Solomon
    428 Solomon
  3. Assen Kirov
    89 Kirov
  4. Elena Nadia Petre
    111 Petre
  5. Mikhail Thomas Silk
    21 Silk
  6. Etay   Ziv
    116 Ziv
  7. Randy Yeh
    71 Yeh
  8. Henry Samuel Kunin
    23 Kunin
  9. Kevin Cerqueira Soares
    142 Soares