Volumetric assessment of the periablational safety margin after thermal ablation of colorectal liver metastases.

Tytuł:: Volumetric assessment of the periablational safety margin after thermal ablation of colorectal liver metastases.
Autorzy:: Laimer G; Interventional Oncology-Microinvasive Therapy (SIP), Department of Radiology, Medical University Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria.
Jaschke N; Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology and Metabolism, Medical University Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria.; Division of Endocrinology and Metabolic Bone Diseases, Department of Medicine III, Technical University of Dresden, Fetscherstr. 74, 01037, Dresden, Germany.
Schullian P; Interventional Oncology-Microinvasive Therapy (SIP), Department of Radiology, Medical University Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria.
Putzer D; Interventional Oncology-Microinvasive Therapy (SIP), Department of Radiology, Medical University Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria.
Eberle G; Interventional Oncology-Microinvasive Therapy (SIP), Department of Radiology, Medical University Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria.
Solbiati M; R&D Unit, R.A.W. Srl, Milan, Italy.
Solbiati L; Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Milan, Italy.; IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy.
Goldberg SN; Department of Radiology, Hadassah Hebrew University Medical Centre, Jerusalem, Israel.; Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Bale R; Interventional Oncology-Microinvasive Therapy (SIP), Department of Radiology, Medical University Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria. .
Źródło:: European radiology [Eur Radiol] 2021 Sep; Vol. 31 (9), pp. 6489-6499. Date of Electronic Publication: 2021 Jan 14.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Original Publication: Berlin : Springer International, c1991-
MeSH Terms:: Catheter Ablation*
Colorectal Neoplasms*/surgery
Liver Neoplasms*/diagnostic imaging
Liver Neoplasms*/surgery
Radiofrequency Ablation*
Adult ; Aged ; Aged, 80 and over ; Humans ; Male ; Margins of Excision ; Middle Aged ; Retrospective Studies ; Treatment Outcome
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Contributed Indexing:: Keywords: Liver neoplasms; Radiofrequency ablation; Tomography, X-ray computed; Treatment outcome
Entry Date(s):: Date Created: 20210115 Date Completed: 20210824 Latest Revision: 20230707
Update Code:: 20240105
PubMed Central ID:: PMC8379110
DOI:: 10.1007/s00330-020-07579-x
PMID:: 33447860
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Objectives: To retrospectively assess the periablational 3D safety margin in patients with colorectal liver metastases (CRLM) referred for stereotactic radiofrequency ablation (RFA) and to evaluate its influence on local treatment success.
Methods: Forty-five patients (31 males; mean age 64.5 [range 31-87 years]) with 76 CRLM were treated with stereotactic RFA and retrospectively analyzed. Image fusion of pre- and post-interventional contrast-enhanced CT scans using a non-rigid registration software enabled a retrospective assessment of the percentage of predetermined periablational 3D safety margin and CRLM successfully ablated. Periablational safety zones (1-10 mm) and percentage of periablational zone ablated were calculated, analyzed, and compared with subsequent tumor growth to determine an optimal safety margin predictive of local treatment success.
Results: Mean overall follow-up was 36.1 ± 18.5 months. Nine of 76 CRLMs (11.8%) developed local tumor progression (LTP) with mean time to LTP of 18.3 ± 11.9 months. Overall 1-, 2-, and 3-year cumulative LTP-free survival rates were 98.7%, 90.6%, and 88.6%, respectively. The periablational safety margin assessment proved to be the only independent predictor (p < 0.001) of LTP for all calculated safety margins. The smallest safety margin 100% ablated displaying no LTP was 3 mm, and at least 90% of a 6-mm circumscribed 3D safety margin was required to achieve complete ablation.
Conclusions: Volumetric assessment of the periablational safety margin can be used as an intraprocedural tool to evaluate local treatment success in patients with CRLM referred to stereotactic RFA. Ablations achieving 100% 3D safety margin of 3 mm and at least 90% 3D safety margin of 6 mm can predict treatment success.
Key Points: • Volumetric assessment of the periablational safety margin can be used as an intraprocedural tool to evaluate local treatment success following thermal ablation of colorectal liver metastases. • Ablations with 100% 3D periablational safety margin of 3 mm and ablations with at least 90% 3D safety margin of 6 mm can be considered indications of treatment success. • Image fusion of pre- and post-interventional CT scans with the software used in this study is feasible and could represent a useful tool in daily clinical practice.
(© 2021. The Author(s).)

Erratum in: Eur Radiol. 2021 Jun 17;:. (PMID: 34142222)

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