Unenhanced magnetic resonance imaging immediately after radiofrequency ablation of liver malignancy: preliminary results

Autor: Andrea Ruzzenente, Valentina Ciaravino, Mirko D'Onofrio, Alfredo Guglielmi, Nicolò Cardobi, Simone Conci, Roberto Pozzi Mucelli
Rok vydání: 2017
Předmět:
Male
medicine.medical_specialty
Carcinoma
Hepatocellular
Percutaneous
Liver RFA
Radiofrequency ablation
Urology
medicine.medical_treatment
Contrast Media
Unenhanced MRI
Ablation
Malignancy
Sensitivity and Specificity
030218 nuclear medicine & medical imaging
law.invention
Lesion
03 medical and health sciences
0302 clinical medicine
Predictive Value of Tests
law
Internal medicine
medicine
Humans
Radiology
Nuclear Medicine and imaging
Prospective Studies
Ultrasonography
Interventional
Aged
Aged
80 and over
Postoperative Care
Radiofrequency Ablation
Radiological and Ultrasound Technology
medicine.diagnostic_test
business.industry
Liver Neoplasms
Gastroenterology
Magnetic resonance imaging
Middle Aged
Hepatology
medicine.disease
Magnetic Resonance Imaging
Coagulative necrosis
Female
030211 gastroenterology & hepatology
Radiology
medicine.symptom
business
Zdroj: Abdominal Radiology. 43:1379-1385
ISSN: 2366-0058
2366-004X
DOI: 10.1007/s00261-017-1299-9
Popis: To assess the accuracy of unenhanced magnetic resonance imaging (MRI) immediately after the percutaneous ultrasound-guided radiofrequency ablation (RFA) of liver malignancy in predicting treatment efficacy at CT follow-up. Percutaneous ablation was prospectively performed in 23 liver malignancies (20 hepatocarcinomas and 3 metastases). After the procedure in the same day all patients were studied with unenhanced MRI. The best sequence to detect the coagulative necrosis was visually established. Pre-RFA CT and post-RFA MRI were registered with non-rigid transformation algorithm. Manual segmentation of lesions and ablated areas in pre-RFA CT, post-RFA MRI, and follow-up CT were obtained. Sensitivity, specificity, positive predictive value (PPV), negative predicitve value (NPV), and accuracy of MRI in predicting the correct centering and the complete treatment of the lesion were calculated in respect to the 1-month follow-up CT. Fat-saturated T1-weighted (fs T1-w) was the sequence in which the best conspicuity of the ablated area was depicted. Coagulative necrosis was hyperintense in fs T1-w sequence in 17/23 (74%). In respect to follow-up CT, MRI predicted the correct centering of the lesions in 19/20 lesions with sensitivity, specificity, PPV, NPV, and accuracy of 100%, 75%, 95%, 100%, and 100%, respectively. MRI predicted the complete treatment of the lesions in 17/17 lesions with sensitivity, specificity, PPV, NPV, and accuracy of 100%. MRI with the single fs T1-w sequence was highly accurate in predicting the treatment efficacy of percutaneous ablation of liver malignancies in comparison to follow-up CT control. Unnecessary CT in case of incomplete treatment can be therefore easily avoided.
Databáze: OpenAIRE
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