Volumetric Quantitative Ablation Margins for Assessment of Ablation Completeness in Thermal Ablation of Liver Tumors.
Volumetric Quantitative Ablation Margins for Assessment of Ablation Completeness in Thermal Ablation of Liver Tumors.
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DOI：
10.3389/fonc.2021.623098
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发表时间：
2021
影响因子：
4.7
通讯作者：
Tinguely P
中科院分区：
文献类型：
--
作者：
Sandu RM;Paolucci I;Ruiter SJS;Sznitman R;de Jong KP;Freedman J;Weber S;Tinguely P
在肝肿瘤的热消融中，具有足够消融边缘的消融体积完全覆盖肿瘤体积是治疗成功的最重要因素。消融完整性的评价通常通过2D目视检查进行，并且易于发生阅片者间差异。本研究旨在引入一种标准化方法，使用体积定量消融边缘（QAM）评价CT引导下肝肿瘤热消融后的消融完整性。开发了一种基于肿瘤和消融区域的体积分割和有符号欧氏表面距离图的QAM计算度量，包括一种解决包膜下肿瘤中QAM计算的新算法。QAM计算的代码在模拟不同消融边缘场景的肿瘤和消融球的人工示例中进行了验证。在从立体定向微波消融（SMWA）治疗结直肠肝转移（CRLM）的前瞻性数据库中提取的代表性病例中研究了QAM度量的适用性。所提出的QAM度量的适用性在人工和临床示例病例中得到证实。提出了QAM分布底层数据表示的数值和可视化选项。对于包膜下肿瘤，确认了在应用未经调整的QAM方法时消融体积对肿瘤覆盖的低估，支持在这些情况下使用所提出的QAM计算算法的益处。已开发的QAM的计算代码已公开，鼓励在报告消融完整性和裕度时使用标准和客观的度量。提出的用于QAM计算的体积方法包括一种解决被膜下肝脏肿瘤的新型算法，可以实现消融边缘评估的精确性和可重复性。消融完整性的定量反馈为术中决策和肝脏肿瘤热消融后局部肿瘤控制的可预测性和一致性的精细分析提供了可能性。
In thermal ablation of liver tumors, complete coverage of the tumor volume by the ablation volume with a sufficient ablation margin is the most important factor for treatment success. Evaluation of ablation completeness is commonly performed by visual inspection in 2D and is prone to inter-reader variability. This work aimed to introduce a standardized approach for evaluation of ablation completeness after CT-guided thermal ablation of liver tumors, using volumetric quantitative ablation margins (QAM). A QAM computation metric based on volumetric segmentations of tumor and ablation areas and signed Euclidean surface distance maps was developed, including a novel algorithm to address QAM computation in subcapsular tumors. The code for QAM computation was verified in artificial examples of tumor and ablation spheres simulating varying scenarios of ablation margins. The applicability of the QAM metric was investigated in representative cases extracted from a prospective database of colorectal liver metastases (CRLM) treated with stereotactic microwave ablation (SMWA). Applicability of the proposed QAM metric was confirmed in artificial and clinical example cases. Numerical and visual options of data presentation displaying substrata of QAM distributions were proposed. For subcapsular tumors, the underestimation of tumor coverage by the ablation volume when applying an unadjusted QAM method was confirmed, supporting the benefits of using the proposed algorithm for QAM computation in these cases. The computational code for developed QAM was made publicly available, encouraging the use of a standard and objective metric in reporting ablation completeness and margins. The proposed volumetric approach for QAM computation including a novel algorithm to address subcapsular liver tumors enables precision and reproducibility in the assessment of ablation margins. The quantitative feedback on ablation completeness opens possibilities for intra-operative decision making and for refined analyses on predictability and consistency of local tumor control after thermal ablation of liver tumors.
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影响因子：
5.9
作者：
Calandri, Marco;Yamashita, Suguru;Odisio, Bruno C.
通讯作者：
Odisio, Bruno C.
影响因子：
19.7
作者：
Heerink, Wouter J.;Ruiter, Simeon J. S.;de Jong, Koert P.
通讯作者：
de Jong, Koert P.
影响因子：
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作者：
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通讯作者：
Harbut, Piotr
DOI：
10.1016/j.jvir.2016.02.031
发表时间：
2016-07-01
影响因子：
2.9
作者：
Hocquelet, Arnaud;Trillaud, Herve;de Senneville, Baudouin Denis
通讯作者：
de Senneville, Baudouin Denis
影响因子：
5.9
作者：
Laimer, Gregor;Schullian, Peter;Bale, Reto
通讯作者：
Bale, Reto