Department of Interventional Radiology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
Department of Interventional Radiology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
Clin Radiol. 2019 Aug;74(8):652.e21-652.e28. doi: 10.1016/j.crad.2019.03.021. Epub 2019 May 7.
To demonstrate the feasibility of magnetic resonance imaging (MRI)-computed tomography (CT) fusion imaging for the assessment of the ablative margin after cryoablation in hepatic malignancies.
This retrospective study analysed 35 patients with 47 liver tumours treated with CT-guided cryoablation. Fusion images of pre-ablation MRI and intraoperative CT data were created on a workstation. Minimal ablative margin (MAM) assessment was categorised into three groups: (I) MAM <0 mm (tumour protruded through the ablation zone), (II) MAM 0-5 mm, and (III) MAM ≥5 mm. Local tumour progression (LTP) was assessed during follow-up.
MRI-CT fusion imaging was successfully achieved in 46 (97.9%) of 47 lesions. LTP was detected in 67.4% (31/46) of cases. Twenty-four (77.4%) of 31 LTPs occurred in the subcapsular region of the liver. Using fusion images, the MAM was classified as groups I, II, and III in 18, 25, and three tumours, respectively. In group I, LTP was found in 15 (83.3%) of 18 lesions, whereas in group II, LTP was detected in 16 (64%) of 25 lesions. The cumulative LTP rate in group II was significantly lower than that in group I (p=0.012).
Pre-ablation MRI and intraoperative CT fusion imaging is feasible and useful for evaluating the MAM of cryoablation in hepatic malignancies.
证明磁共振成像（MRI）-计算机断层扫描（CT）融合成像在评估肝恶性肿瘤冷冻消融后消融边界的可行性。
本回顾性研究分析了 35 例 47 个肝脏肿瘤患者，这些患者接受了 CT 引导下冷冻消融治疗。在工作站上创建了术前 MRI 和术中 CT 数据的融合图像。最小消融边界（MAM）评估分为三组：（I）MAM<0mm（肿瘤突出消融区），（II）MAM0-5mm，和（III）MAM≥5mm。在随访期间评估局部肿瘤进展（LTP）。
47 个病灶中的 46 个（97.9%）成功实现了 MRI-CT 融合成像。67.4%（31/46）的病例检测到 LTP。31 个 LTP 中有 24 个（77.4%）发生在肝脏的包膜下区域。使用融合图像，MAM 在 18 个肿瘤中分为 I、II 和 III 组，在 25 个肿瘤中分为 I、II 和 III 组，在 3 个肿瘤中分为 I、II 和 III 组。在 I 组中，18 个病灶中有 15 个（83.3%）发现 LTP，而在 II 组中，25 个病灶中有 16 个（64%）发现 LTP。与 I 组相比，II 组的累积 LTP 率明显较低（p=0.012）。
术前 MRI 和术中 CT 融合成像对于评估肝恶性肿瘤冷冻消融的 MAM 是可行且有用的。
