Value of spectral detector computed tomography for the early assessment of technique efficacy after microwave ablation of hepatocellular carcinoma

To investigate whether virtual monoenergetic images (VMI) and iodine maps derived from spectral detector computed tomography (SDCT) improve early assessment of technique efficacy in patients who underwent microwave ablation (MWA) for hepatocellular carcinoma (HCC) in liver cirrhosis. This retrospect...

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Vydané v:PloS one Ročník 16; číslo 6; s. e0252678
Hlavní autori: Reimer, Robert Peter, Hokamp, Nils Große, Niehoff, Julius, Zopfs, David, Lennartz, Simon, Heidar, Mariam, Wahba, Roger, Stippel, Dirk, Maintz, David, dos Santos, Daniel Pinto, Wybranski, Christian
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: San Francisco Public Library of Science 15.06.2021
Public Library of Science (PLoS)
Predmet:
Ablation
Ablation (Surgery)
Biology and Life Sciences
Cancer
Care and treatment
Computed tomography
Conspicuity
CT imaging
Data analysis
Diagnostic systems
Editing
Energy
Evaluation
Global health
Hepatocellular carcinoma
Hepatoma
Hospitals
Hybrid systems
Information systems
Iodine
Liver
Liver cancer
Magnetic resonance imaging
Medical imaging
Medicine
Medicine and Health Sciences
Methodology
Microwave ablation
Patient outcomes
Physical Sciences
Public health
Radiology
Research and Analysis Methods
Sensors
Surgery
Visualization
Germany
ISSN:1932-6203, 1932-6203
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Popis
Shrnutí:To investigate whether virtual monoenergetic images (VMI) and iodine maps derived from spectral detector computed tomography (SDCT) improve early assessment of technique efficacy in patients who underwent microwave ablation (MWA) for hepatocellular carcinoma (HCC) in liver cirrhosis. This retrospective study comprised 39 patients with 49 HCC lesions treated with MWA. Biphasic SDCT was performed 7.7±4.0 days after ablation. Conventional images (CI), VMI and IM were reconstructed. Signal- and contrast-to-noise ratio (SNR, CNR) in the ablation zone (AZ), hyperemic rim (HR) and liver parenchyma were calculated using regions-of-interest analysis and compared between CI and VMI between 40-100 keV. Iodine concentration and perfusion ratio of HR and residual tumor (RT) were measured. Two readers evaluated subjective contrast of AZ and HR, technique efficacy (complete vs. incomplete ablation) and diagnostic confidence at determining technique efficacy. Attenuation of liver parenchyma, HR and RT, SNR of liver parenchyma and HR, CNR of AZ and HR were significantly higher in low-keV VMI compared to CI (all p<0.05). Iodine concentration and perfusion ratio differed significantly between HR and RT (all p<0.05; e.g. iodine concentration, 1.6±0.5 vs. 2.7±1.3 mg/ml). VMI.sub.50keV improved subjective AZ-to-liver contrast, HR-to-liver contrast, visualization of AZ margin and vessels adjacent to AZ compared to CI (all p<0.05). Diagnostic accuracy for detection of incomplete ablation was slightly higher in VMI.sub.50keV compared to CI (0.92 vs. 0.89), while diagnostic confidence was significantly higher in VMI.sub.50keV (p<0.05). Spectral detector computed tomography derived low-keV virtual monoenergetic images and iodine maps provide superior early assessment of technique efficacy of MWA in HCC compared to CI.
Bibliografia:ObjectType-Article-1
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Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: David Maintz and Nils Große Hokamp received speaker’s honor from Philips Healthcare. Nils Große Hokamp, David Zopfs and Simon Lennartz received research support unrelated to this project. This does not alter our adherence to PLOS ONE policies on sharing data and materials. All other authors have declared that no competing interest exist.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0252678