Advanced CT techniques for hepatic microwave ablation zone monitoring and follow-up

Purpose To evaluate utility of advanced CT techniques including HighlY constrained back-projection and dual-energy CT for intra- and post-procedure hepatic microwave ablation zone monitoring. Methods 8 hepatic microwave ablations were performed in 4 adult swine (5 min/65 W). Low-dose routine CECT an...

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Bibliographic Details
Published in:Abdominal imaging 2022-08, Vol.47 (8), p.2658-2668
Main Authors: Lubner, Meghan G., Ziemlewicz, Timothy J., Wells, Shane A., Li, Ke, Wu, Po-Hung, Hinshaw, J. Louis, Lee, Fred T., Brace, Chris L.
Format: Article
Language:English
Subjects:
Ablation
Adult
Animals
Carcinoma, Hepatocellular
Computed tomography
Contrast Media
Dosage
Follow-Up Studies
Gastroenterology
Hepatology
Humans
Image quality
Image reconstruction
Imaging
Iodine
Liver
Liver Neoplasms - diagnostic imaging
Liver Neoplasms - surgery
Medical imaging
Medicine
Medicine & Public Health
Metastases
Microwave ablation
Microwaves - therapeutic use
Middle Aged
Monitoring
Radiation
Radiation Dosage
Radiology
Special Section: Cross sectional interventions
Swine
Tomography
Tomography, X-Ray Computed - methods
Tumors
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Summary:Purpose To evaluate utility of advanced CT techniques including HighlY constrained back-projection and dual-energy CT for intra- and post-procedure hepatic microwave ablation zone monitoring. Methods 8 hepatic microwave ablations were performed in 4 adult swine (5 min/65 W). Low-dose routine CECT and dual-energy CT images were obtained every 1 min during ablation. Images were reconstructed ± HYPR. Image quality and dose metrics were collected. 21 MWA were performed in 4 adult swine. Immediate post-procedure CECT was performed in the arterial, portal venous, and delayed phases using both routine and DECT imaging with full-dose weight-based IV contrast dosing. An additional 16 MWA were subsequently performed in 2 adult swine. Immediate post-procedure CT was performed with half-dose IV contrast using routine and DECT. 12 patients (10 M/2F, mean age 62.4 yrs) with 14 hepatic tumors (4 HCC, 10 metastatic lesions) treated with MWA were prospectively imaged with DECT 1 month post-procedure. 120 kV equivalent images were compared to DECT [51 keV, iodine material density]. Image quality and dose metrics were collected. Results Gas created during MWA led to high CNR in all intraprocedural CT datasets. Optimal CNRs were noted at 4 min with CNR 6.7, 15.5,15.9, and 21.5 on LD-CECT, LD-CECT + HYPR, DECT, and DECT + HYPR, respectively ( p  
ISSN:2366-0058
2366-004X
2366-0058
DOI:10.1007/s00261-021-03333-z