%0 Journal Article
%T A novel software platform for volumetric assessment of ablation completeness
%A Aless
%A Ilaria Marre
%A Katia M Passera
%A Luigi Solbiati
%A Marco Solbiati
%A Riccardo Muglia
%A S. Nahum Goldberg
%A Tiziana Ierace
%A ro Rotilio
%J International Journal of Hyperthermia
%D 2019
%R https://doi.org/10.1080/02656736.2019.1569267
%X Abstract Purpose: To retrospectively evaluate the accuracy of a novel software platform for assessing completeness of percutaneous thermal ablations. Materials & methods: Ninety hepatocellular carcinomas (HCCs) in 50 patients receiving percutaneous ultrasound-guided microwave ablation (MWA) that resulted in apparent technical success at 24-h post-ablation computed tomography (CT) and with ¡İ1-year imaging follow-up were randomly selected from a 320 HCC ablation database (2010¨C2016). Using a novel volumetric registration software, pre-ablation CT volumes of the HCCs without and with the addition of a 5£¿mm safety margin, and corresponding post-ablation necrosis volumes were segmented, co-registered and overlapped. These were compared to visual side-by-side inspection of axial images. Results: At 1-year follow-up, CT showed absence of local tumor progression (LTP) in 69/90 (76.7%) cases and LTP in 21/90 (23.3%). For HCCs classified by the software as ¡°incomplete tumor treatments¡±, LTP developed in 13/17 (76.5%) and all 13 (100%) of these LTPs occurred exactly where residual non-ablated tumor was identified by retrospective software analysis. HCCs classified as ¡°complete ablation with <100% 5£¿mm ablative margins¡± had LTP in 8/49 (16.3%), while none of 24 HCCs with ¡°complete ablation including 100% 5£¿mm ablative margins¡± had LTP. Differences in LTP between both partially ablated HCCs vs completely ablated HCCs, and ablated HCCs with <100% vs with 100% 5£¿mm margins were statistically significant (p£¿<£¿.0001 and p£¿=£¿.036, respectively). Thus, 13/21 (61.9%) incomplete tumor treatments could have been detected immediately, were the software available at the time of ablation. Conclusions: A novel software platform for volumetric assessment of ablation completeness may increase the detection of incompletely ablated tumors, thereby holding the potential to avoid subsequent recurrences
%U https://www.tandfonline.com/doi/full/10.1080/02656736.2019.1569267