Assessment of liver ablation using cone beam computed tomography

Figure 1 Illustration of a poor quality cone beam computed tomography image obtained in a 65-year-old man with hepatocellular carcinoma on hepatitis C virus cirrhosis background. A: Visibility of the ablation zone is poor (arrow); B: Post-ablation multi-detector computed tomography performed at 6 wk showed complete ablation.

Figure 2 A 53-year-old man with small hepatocellular carcinoma in the right liver. On baseline arterial phase axial and coronal contrast-enhanced multidetector computed tomography (MDCT) (A and B), the tumor was hypervascular (arrow). On axial and coronal contrast-enhanced cone beam computed tomography (CBCT) immediately after radiofrequency ablation (C and D), the ablation zone was clear and markedly hypoattenuating. Image fusion performed between baseline arterial phase contrast-enhanced MDCT and contrast-enhanced CBCT showed satisfactory tumor coverage (E). The ablation zone is clearly visible on 1-mo post-procedural axial and coronal contrast-enhanced MDCT (F and G). The volume of necrosis obtained from contrast-enhanced CBCT and 1-mo post-procedural contrast-enhanced MDCT was similar.

Figure 3 Comparison of cone beam computed tomography with baseline multidetector computed tomography, and 1-2 mo multidetector computed tomography. A: Correlation between ablation zone volumes calculated from cone beam computed tomography (CBCT) images and those from 1-2 mo post-procedural multidetector computed tomography (MDCT) images; B: Bland and Altman limits of agreement for the ablation zone volumes measured on CBCT and MDCT.