Characteristic changes of the ablation zone on contrast-enhanced computed tomography after radiofrequency ablation of hepatic metastases

Abstract

Purpose: Size and density measurements of the ablation zones on contrast-enhanced computed tomography (CT) after radiofrequency ablation (RFA) of hepatic metastases of primary breast or colorectal cancer were acquired over time. Materials and Methods: Twenty-five liver metastases [colorectal cancer (CRC): n = 16; mean size: 19.6 ± 8.5 mm; breast cancer (BC): n = 9; 27.9 ± 13.6 mm] in 15 patients (CRC: n = 11; age: 65.4 ± 6.5 years; BC: n = 4; 62.0 ± 13.8 years) treated by RFA were included in this retrospective study. All patients had undergone postinterventional serial follow-up using multidetector CT (MDCT) (1 day/1/4/7/10/14/18/23/>24 months) without evidence of local tumor recurrence during the follow-up. The ablation zones were evaluated using a commercial software tool (Syngo CT Oncology) in order to determine volumetric, RECIST-, WHO- and density changes over the course of time. Results were compared by applying repeated measures analysis of variance and displayed graphically. Results: The RF ablation zones demonstrated significant shrinkage (P ≤ 0.05) over the first 7 months (volume, RECIST, WHO) of the follow-up. Follow-up after 7 months did not show any significant changes in size (P > 0.05) (mean volume (ml): 55.2/34.7/26.3/16.5/12.7/10.0/8.9/8.1/7.5; RECIST (mm): 58.7/49.3/43.7/37.8/34.2/31.3/29.1/27.3/24.8; WHO (mm2): 2458.3/1769.3/1341.8/1027.1/870.1/720.2/649.0/570.4/511.3). Mean density values decreased significantly between 1 day (58.9 HU) and 1 month (47.5 HU) after the procedure. Conclusion: Typical changes in size and density values of RF-induced, recurrence-free ablation zones after RFA of hepatic metastases of colorectal and breast cancer were acquired, showing a significant decrease in density of the ablation zone within the first month and significant shrinkage within the first 7 months after RFA.

Keywords

Ablation zone - automated evaluation - hepatic metastases - radiofrequency ablation

Publication History

Article published online:
26 July 2021

• References

• 1 Boyle P, Ferlay J. Cancer incidence and mortality in Europe, 2004. Ann Oncol 2005; 16: 481-8
• 2 Benson 3rd AB. Epidemiology, disease progression, and economic burden of colorectal cancer. J Manag Care Pharm 2007; 13: 5-18
• 3 Greenlee RT, Hill-Harmon MB, Murray T, Thun M. Cancer statistics, 2001. CA Cancer J Clin 2001; 51: 15-36
• 4 Gillams AR, Lees WR. Radio-frequency ablation of colorectal liver metastases in 167 patients. Eur Radiol 2004; 14: 2261-7
• 5 Jakobs TF, Hoffmann RT, Schrader A, Stemmler HJ, Trumm C, Lubienski A. et al. CT-guided radiofrequency ablation in patients with hepatic metastases from breast cancer. Cardiovasc Intervent Radiol 2009; 32(1): 38-46
• 6 de Baere T, Elias D, Dromain C, Din MG, Kuoch V, Ducreux M. et al. Radiofrequency ablation of 100 hepatic metastases with a mean follow-up of more than 1 year. AJR Am J Roentgenol 2000; 175: 1619-25
• 7 Wood TF, Rose DM, Chung M, Allegra DP, Foshag LJ, Bilchik AJ. Radiofrequency ablation of 231 unresectable hepatic tumors: indications, limitations, and complications. Ann Surg Oncol 2000; 7: 593-600
• 8 Dromain C, de Baere T, Elias D, Kuoch V, Ducreux M, Boige V. et al. Hepatic tumors treated with percutaneous radio-frequency ablation: CT and MR imaging follow-up. Radiology 2002; 223: 255-62
• 9 Goldberg SN, Grassi CJ, Cardella JF, Charboneau JW, Dodd 3rd GD, Dupuy DE. et al Image-guided tumor ablation: Standardization of terminology and reporting criteria. Radiology 2005; 235: 728-39
• 10 Park MH, Rhim H, Kim YS, Choi D, Lim HK, Lee WJ. Spectrum of CT findings after radiofrequency ablation of hepatic tumors. Radiographics 2008; 28: 379-90 ; discussion 390-2
• 11 Keil S, Bruners P, Ohnsorge L, Plumhans C, Behrendt FF, Stanzel S. et al. Semiautomated versus manual evaluation of liver metastases treated by radiofrequency ablation. J Vasc Interv Radiol 2010; 21: 245-51
• 12 Lim HK, Choi D, Lee WJ, Kim SH, Lee SJ, Jang HJ. et al. Hepatocellular carcinoma treated with percutaneous radio-frequency ablation: evaluation with follow-up multiphase helical CT. Radiology 2001; 221: 447-54
• 13 Mulier S, Ni Y, Jamart J, Ruers T, Marchal G, Michel L. Local recurrence after hepatic radiofrequency coagulation: Multivariate meta-analysis and review of contributing factors. Ann Surg 2005; 242: 158-71
• 14 Gazelle GS, Goldberg SN, Solbiati L, Livraghi T. Tumor ablation with radio-frequency energy. Radiology 2000; 217: 633-46
• 15 McGhana YK, McGhana JP, Dodd 3rd GD. Radiofrequency ablation of the liver: Current status. AJR Am J Roentgenol 2001; 176: 3-16
• 16 Goldberg SN, Dupuy DE. Image-guided radiofrequency tumor ablation: Challenges and opportunities—Part I. J Vasc Interv Radiol 2001; 12: 1020-32
• 17 Dupuy DE, Goldberg SN. Image-guided radiofrequency tumor ablation: Challenges and opportunities—Part II. J Vasc Interv Radiol 2001; 12: 1135-48
• 18 Goldberg SN, Gazelle SG, Mueller PR. Thermal ablation therapy for focal malignancy: A unified approach to underlying principles, techniques, and diagnostic imaging guidance. AJR Am J Roentgenol 2000; 174: 323-31
• 19 Livraghi T, Goldberg SN, Lazzaroni S, Meloni F, Ierace T, Solbiati L. et al. Hepatocellular carcinoma: Radio-frequency ablation of medium and large lesions. Radiology 2000; 214: 761-8
• 20 Buscarini E, Buscarini L. Radiofrequency thermal ablation with expandable needle of focal liver malignancies: Complication report. Eur Radiol 2004; 14: 31-7
• 21 Kuehl H, Antoch G, Stergar H, Veit-Haibach P, Rosenbaum-Krumme S, Vogt F. et al. Comparison of FDG-PET, PET/CT and MRI for follow-up of colorectal liver metastases treated with radiofrequency ablation: Initial results. Eur J Radiol 2008; 67 (2): 362-71
• 22 Samim M, Molenaar IQ, Seesing MF, van Rossum PS, van den Bosch MA, Ruers TJ. et al The diagnostic performance of 18F-FDG PET/CT, CT and MRI in the treatment evaluation of ablation therapy for colorectal liver metastases: A systematic review and meta-analysis. Surg Oncol 2017; 26: 37-45
• 23 Heussel CP, Meier S, Wittelsberger S, Götte H, Mildenberger P, Kauczor HU. Follow-up CT measurement of liver malignoma according to RECIST and WHO vs volumetry. Fortschr Röntgenstr 2007; 179: 958-64
• 24 Fabel M, von Tengg-Kobligk H, Giesel FL, Bornemann L, Dicken V, Kopp-Schneider A. et al. Semi-automated volumetric analysis of lymph node metastases in patients with malignant melanoma stage III/IV—a feasibility study. Eur Radiol 2008; 18: 1114-22
• 25 Wormanns D, Kohl G, Klotz E, Marheine A, Beyer F, Heindel W. et al. Volumetric measurements of pulmonary nodules at multi-row detector CT: In vivo reproducibility. Eur Radiol 2004; 14: 86-92
• 26 Ahmed M, Solbiati L, Brace CL, Breen DJ, Callstrom MR, Charboneau JW. et al.Image-guided tumor ablation: Standardization of terminology and reporting criteria—a 10‑year update. J Vasc Interv Radiol 2014;25:1691-705.e4.
• 27 Brace 1 CL, Diaz TA, Hinshaw JL, Lee FTJr. Tissue contraction caused by radiofrequency and microwave ablation: A laboratory study in liver and lung. J Vasc Interv Radiol 2010; 21: 1280-6