Three-dimensional margin as a predictor of local tumor progression after microwave ablation: Intraprocedural versus 4–8-week postablation assessment Journal Article
| Authors: | Zirakchian Zadeh, M.; Sotirchos, V. S.; Kirov, A.; Lafontaine, D.; Gönen, M.; Yeh, R.; Kunin, H.; Petre, E. N.; Kitsel, Y.; Elsayed, M.; Solomon, S. B.; Erinjeri, J. P.; Schwartz, L. H.; Sofocleous, C. T. |
| Article Title: | Three-dimensional margin as a predictor of local tumor progression after microwave ablation: Intraprocedural versus 4–8-week postablation assessment |
| Abstract: | Purpose: To evaluate the prognostic accuracy of intraprocedural and 4–8-week (current standard) post–microwave ablation zone (AZ) and margin assessments for prediction of local tumor progression (LTP) using 3-dimensional (3D) software. Materials and Methods: Data regarding 100 colorectal liver metastases (CLMs) in 75 patients were collected from 2 prospective fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT)–guided microwave ablation (MWA) trials. The target CLMs and theoretical 5- and 10-mm margins were segmented and registered intraprocedurally and at 4–8 weeks after MWA contrast-enhanced CT (or magnetic resonance [MR] imaging) using the same methodology and 3D software. Tumor and 5- and 10-mm minimal margin (MM) volumes not covered by the AZ were defined as volumes of insufficient coverage (VICs). The intraprocedural and 4–8-week post-MWA VICs were compared as predictors of LTP using receiver operating characteristic curve analysis. Results: The median follow-up time was 19.6 months (interquartile range, 7.97–36.5 months). VICs for 5- and 10-mm MMs were predictive of LTP at both time assessments. The highest accuracy for the prediction of LTP was documented with the intra-ablation 5-mm VIC (area under the curve [AUC], 0.78; 95% confidence interval, 0.66–0.89). LTP for a VIC of 6–10-mm margin category was 11.4% compared with 4.3% for >10-mm margin category (P < .001). Conclusions: A 3D 5-mm MM is a critical endpoint of thermal ablation, whereas optimal local tumor control is noted with a 10-mm MM. Higher AUCs for prediction of LTP were achieved for intraprocedural evaluation than for the 4–8-week postablation 3D evaluation of the AZ. © 2024 SIR |
| Keywords: | adult; controlled study; middle aged; major clinical study; area under the curve; nuclear magnetic resonance imaging; follow up; biological marker; prediction; tumor growth; cancer control; receiver operating characteristic; colorectal liver metastasis; human; male; female; article; positron emission tomography-computed tomography; microwave thermotherapy; mri scanner |
| Journal Title: | Journal of Vascular and Interventional Radiology |
| Volume: | 35 |
| Issue: | 4 |
| ISSN: | 1051-0443 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2024-04-01 |
| Start Page: | 523 |
| End Page: | 532.e1 |
| Language: | English |
| DOI: | 10.1016/j.jvir.2024.01.001 |
| PUBMED: | 38215818 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Corresponding author is MSK author: Constantinos T. Sofocleous -- Source: Scopus |
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