Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 14, 2015; 21(2): 517-524
Published online Jan 14, 2015. doi: 10.3748/wjg.v21.i2.517
Assessment of liver ablation using cone beam computed tomography
Mohamed Abdel-Rehim, Maxime Ronot, Annie Sibert, Valérie Vilgrain
Mohamed Abdel-Rehim, Maxime Ronot, Annie Sibert, Valérie Vilgrain, Department of Radiology, APHP, University Hospitals Paris Nord Val de Seine, 92110 Clichy, France
Maxime Ronot, Valérie Vilgrain, University Paris Diderot, Sorbonne Paris Cité, 75012 Paris, France
Maxime Ronot, Valérie Vilgrain, INSERM U1149, Centre de Recherche Biomédicale Bichat-Beaujon, CRB3, 75018 Paris, France
Author contributions: Abdel-Rehim M and Ronot M contributed equally to this work; Abdel-Rehim M, Ronot M and Vilgrain V designed the research; Abdel-Rehim M, Ronot M and Sibert A acquired the data; Ronot M and Vilgrain V analyzed the data; and all authors wrote the paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Maxime Ronot, MD, PhD, Associate Professor, Department of Radiology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, 100 bd du Général Leclerc, 92110 Clichy, France. maxime.ronot@bjn.aphp.fr
Telephone: +33-1-40875358 Fax: +33-1-40870548
Received: April 30, 2014
Peer-review started: May 2, 2014
First decision: June 10, 2014
Revised: August 4, 2014
Accepted: October 15, 2014
Article in press: October 15, 2014
Published online: January 14, 2015
Abstract

AIM: To investigate the feasibility and accuracy of cone beam computed tomography (CBCT) in assessing the ablation zone after liver tumor ablation.

METHODS: Twenty-three patients (17 men and 6 women, range: 45-85 years old, mean age 65 years) with malignant liver tumors underwent ultrasound-guided percutaneous tumor ablation [radiofrequency (n = 14), microwave (n = 9)] followed by intravenous contrast-enhanced CBCT. Baseline multidetector computed tomography (MDCT) and peri-procedural CBCT images were compared. CBCT image quality was assessed as poor, good, or excellent. Image fusion was performed to assess tumor coverage, and quality of fusion was rated as bad, good, or excellent. Ablation zone volumes on peri-procedural CBCT and post-procedural MDCT were compared using the non-parametric paired Wilcoxon t-test.

RESULTS: Rate of primary ablation effectiveness was 100%. There were no complications related to ablation. Local tumor recurrence and new liver tumors were found 3 mo after initial treatment in one patient (4%). The ablation zone was identified in 21/23 (91.3%) patients on CBCT. The fusion of baseline MDCT and peri-procedural CBCT images was feasible in all patients and showed satisfactory tumor coverage (at least 5-mm margin). CBCT image quality was poor, good, and excellent in 2 (9%), 8 (35%), and 13 (56%), patients respectively. Registration quality between peri-procedural CBCT and post-procedural MDCT images was good to excellent in 17/23 (74%) patients. The median ablation volume on peri-procedural CBCT and post-procedural MDCT was 30 cm3 (range: 4-95 cm3) and 30 cm3 (range: 4-124 cm3), respectively (P-value > 0.2). There was a good correlation (r = 0.79) between the volumes of the two techniques.

CONCLUSION: Contrast-enhanced CBCT after tumor ablation of the liver allows early assessment of the ablation zone.

Keywords: Ablation, Cone beam computed tomography, Liver, Malignancies, Radiofrequency

Core tip: Immediate intravenous contrast-enhanced cone beam computed tomography after percutaneous tumor ablation of the liver provides early assessment of the ablation zone and may provide the same information as multidetector computed tomography (MDCT) performed 1-2 mo after ablation. This is particularly interesting for centers that do not have MDCT in interventional rooms.