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CT-monitored minimal ablative margin control in single-session microwave ablation of liver tumors: an effective strategy for local tumor control
DC Field | Value | Language |
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dc.contributor.author | Joo, Ijin | - |
dc.contributor.author | Morrow, Kenneth W. | - |
dc.contributor.author | Raman, Steven S. | - |
dc.contributor.author | McWilliams, Justin P. | - |
dc.contributor.author | Sayre, James W. | - |
dc.contributor.author | Lu, David S. | - |
dc.date.accessioned | 2022-09-30T05:54:22Z | - |
dc.date.available | 2022-09-30T05:54:22Z | - |
dc.date.created | 2022-08-26 | - |
dc.date.issued | 2022-09 | - |
dc.identifier.citation | European Radiology, Vol.32 No.9, pp.6327-6335 | - |
dc.identifier.issn | 0938-7994 | - |
dc.identifier.uri | https://hdl.handle.net/10371/184998 | - |
dc.description.abstract | Objectives To investigate the usefulness of minimal ablative margin (MAM) control by intra-procedural contrast-enhanced CT (CECT) in microwave ablation (MWA) of liver tumors. Methods A total of 334 consecutive liver tumors (240 hepatocellular carcinomas [HCCs] and 94 colorectal liver metastases [CRLMs]) in 172 patients treated with percutaneous MWA were retrospectively included. MAM of each tumor was assessed after expected ablation completion using intra-procedural CECT, allowing within-session additional ablation to any potentially insufficient margin. On immediate post-MWA MRI, complete ablation coverage of tumor and final MAM status were determined. The cumulative local tumor progression (LTP) rate was estimated by using the Kaplan-Meier method. To identify predictors of LTP, Cox regression analysis with a shared frailty model was performed. Results Intra-procedural CECT findings prompted additional ablation in 18.9% (63/334) of tumors. Final complete ablation coverage of tumor and sufficient MAM were determined by MRI to be achieved in 99.4% (332/334) and 77.5% (259/334), and their estimated 6-month, 1-year, and 2-year LTP rates were 3.2%, 7.5%, and 12.9%; and 1.0%, 2.1%, and 6.9%, respectively. Insufficient MAM on post-MWA MRI, perivascular tumor location, and tumor size (cm) were independent risk factors for LTP (hazard ratio = 14.4, 6.0, and 1.1, p < 0.001, p = 0.003, and p = 0.011, respectively), while subcapsular location and histology (HCC vs CRLM) were not. Conclusions In MWA of liver tumors, intra-procedural CECT monitoring of minimal ablative margin facilitates identification of potentially suboptimal margins and guides immediate additional intra-session ablation to maximize rates of margin-sufficient ablations, the latter being a highly predictive marker for excellent long-term local tumor control. | - |
dc.language | 영어 | - |
dc.publisher | Springer Verlag | - |
dc.title | CT-monitored minimal ablative margin control in single-session microwave ablation of liver tumors: an effective strategy for local tumor control | - |
dc.type | Article | - |
dc.identifier.doi | 10.1007/s00330-022-08723-5 | - |
dc.citation.journaltitle | European Radiology | - |
dc.identifier.wosid | 000781051700002 | - |
dc.identifier.scopusid | 2-s2.0-85127697977 | - |
dc.citation.endpage | 6335 | - |
dc.citation.number | 9 | - |
dc.citation.startpage | 6327 | - |
dc.citation.volume | 32 | - |
dc.description.isOpenAccess | N | - |
dc.contributor.affiliatedAuthor | Joo, Ijin | - |
dc.type.docType | Article | - |
dc.description.journalClass | 1 | - |
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