A novel software platform for volumetric assessment of ablation completeness

• Published in: International journal of hyperthermia 2019-01, Vol.36 (1), p.336-342
• Main Authors: Solbiati, Marco, Muglia, Riccardo, Goldberg, S. Nahum, Ierace, Tiziana, Rotilio, Alessandro, Passera, Katia M, Marre, Ilaria, Solbiati, Luigi
• Format: Article
• Language: English
• Subjects: 3D rendering; ablation; Aged; Aged, 80 and over; Catheter Ablation - methods; Female; Humans; image processing; Male; Middle Aged; Retrospective Studies; Software
• ISSN: 0265-6736; 1464-5157
• DOI: 10.1080/02656736.2019.1569267

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 ≥1-year imaging follow-up were randomly selected from a 320 HCC ablation database (2010-2016). 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