Assessing ablation margins of FDG-avid liver tumors during PET/CT-guided thermal ablation procedures: a retrospective study

Assessing ablation margins of FDG-avid liver tumors during PET/CT-guided thermal ablation procedures: a retrospective study
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DOI:
10.1007/s00259-021-05206-5
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发表时间:
2021-02-09
影响因子:
9.1
通讯作者:
Shyn, Paul B.
Shyn, Paul B.
中科院分区:
医学1区
文献类型:
--
作者:
Casadaban, Leigh C.;Catalano, Paul J.;Shyn, Paul B.

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背景使用FDG PET/CT引导微波或冷冻消融术的术中PET/CT图像回顾性评估肝脏肿瘤消融边缘,并将最小边缘测量值与局部进展结局相关联。方法五十六例患者(年龄36 ~ 85岁,中位数62岁;女性32例)共77个FDG阳性肝肿瘤,在PET/CT引导下,经皮微波或冷冻消融治疗60个FDG阳性肝肿瘤。单次屏气PET/CT图像用于肿瘤消融边缘的术中评估:消融后立即在PET上保持可见肝脏肿瘤;使用对比增强CT可见微波消融区;使用未增强CT可见冷冻消融区(冰球)。两名阅片师回顾性确定了消融边缘可评估性,并在术中PET/CT(n = 77)和术后MRI(n = 56)上测量了最小消融边缘。在所有可用的随访成像(1-49个月,平均15个月)上评估局部肿瘤进展。局部肿瘤进展与PET/CT最小边缘测量值相关,使用聚类生存模型对61个肿瘤进行了研究。结果术中PET/CT(>= 73/77,95%)比术后MRI(
Background To retrospectively assess liver tumor ablation margins using intraprocedural PET/CT images from FDG PET/CT-guided microwave or cryoablation procedures and to correlate minimum margin measurements with local progression outcomes. Methods Fifty-six patients (ages 36 to 85, median 62; 32 females) with 77 FDG-avid liver tumors underwent 60 FDG PET/CT guided, percutaneous microwave, or cryoablation procedures. Single breath-hold PET/CT images were used for intraprocedural assessment of the tumor ablation margin: liver tumors remained visible on PET immediately following ablation; microwave ablation zones were visible using contrast-enhanced CT; cryoablation zones (ice balls) were visible using unenhanced CT. Two readers retrospectively determined ablation margin assessability and measured the minimum ablation margin on intraprocedural PET/CT (n = 77) and postprocedural MRI (n = 56). Local tumor progression was assessed on all available follow-up imaging (1-49 months, mean 15). Local tumor progression was correlated with PET/CT minimum margin measurements using clustered survival models for 61 tumors. Results Minimum ablation margins were more often assessable using intraprocedural PET/CT (>= 73/77 tumors, 95%) than postprocedural MRI (