研究目的
To evaluate the clinical impact of using registration software for ablative margin assessment on pre-radiofrequency ablation (RFA) magnetic resonance imaging (MRI) and post-RFA computed tomography (CT) compared with the conventional side-by-side MR-CT visual comparison.
研究成果
Non-rigid registration software provided better ablative margin assessment than did visual inspection in patients who had undergone pre-RFA MRI and post-RFA CT for the prediction of LTP after RFA, and it may provide more precise risk stratification of those who are treated with RFA.
研究不足
The relatively small number of study patients with heterogeneous tumor characteristics may have weakened the statistical power of several variables. Pre-RFA MRI was taken on two different scanners with different parameters including slice thicknesses, which may have affected image registration quality. Index tumor size, which is a well-known risk factor for LTP after RFA, was not significantly associated with LTP in our study. We did not test inter-reader agreement in each evaluation method.
1：Experimental Design and Method Selection:
A prospective study was conducted with 68 patients with 88 hepatocellular carcinomas (HCCs) who had undergone pre-RFA MRI. Pre-RFA MRI and post-RFA CT images were analyzed to evaluate the presence of a sufficient safety margin (≥ 3 mm) using either side-by-side visual comparison or non-rigid registration software.
2：Sample Selection and Data Sources:
Patients with 1–3 tumors (< 5 cm) who had liver MR images of sufficient quality for pre-RFA evaluation within 30 days of RFA were enrolled.
3：List of Experimental Equipment and Materials:
Gadoxetic acid-enhanced liver MRI was performed at
4：5T or 3T. RFA was performed under ultrasound guidance using a multi-channel generator system with three channels and three RF generators. Post-RFA CT was performed at a 16-channel scanner. Experimental Procedures and Operational Workflow:
Pre-RFA MRI and post-RFA CT images were analyzed to evaluate the presence of a sufficient safety margin using either side-by-side visual comparison or non-rigid registration software. Patients with an insufficient ablative margin underwent additional treatment.
5：Data Analysis Methods:
Unweighted kappa values were obtained to evaluate the degree of agreement between visual assessment and registration software. Statistical differences were determined using the Student t test and chi-square test. Comparison of the cumulative incidences of LTP was made using Kaplan-Meier analysis.
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