Clinical usefulness of the ablative margin assessed by magnetic resonance imaging with Gd-EOB-DTPA for radiofrequency ablation of hepatocellular carcinoma
Background & Aims The aim of this study was to investigate the feasibility of ablative margin (AM) grading by magnetic resonance imaging (MRI) with Gd-EOB-DTPA administered prior to radiofrequency ablation (RFA), and to identify factors for achieving a sufficient AM and predictors for local tumo...
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| Veröffentlicht in: | Journal of hepatology 2015-12, Vol.63 (6), p.1360-1367 |
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| creator | Koda, Masahiko Tokunaga, Shiho Okamoto, Toshiaki Hodozuka, Masanori Miyoshi, Kennichi Kishina, Manabu Fujise, Yuki Kato, Jun Matono, Tomomitsu Sugihara, Takaaki Oyama, Kenji Hosho, Keiko Okano, Jun-ichi Murawaki, Yoshikazu Kakite, Suguru Yamashita, Eijiro |
| description | Background & Aims The aim of this study was to investigate the feasibility of ablative margin (AM) grading by magnetic resonance imaging (MRI) with Gd-EOB-DTPA administered prior to radiofrequency ablation (RFA), and to identify factors for achieving a sufficient AM and predictors for local tumor progression. Methods A total of 124 hepatocellular carcinomas (HCCs) were treated by RFA after Gd-EOB-DTPA administration. MRI and enhanced CT were performed within seven hours and one month after RFA. The AM assessment was categorized using three grades: AM (+), low-intensity area with continuous high-intensity rim; AM zero, low-intensity area with discontinuous high-intensity rim; and AM (−), low-intensity area extends beyond the high-intensity rim. Patients were followed and local tumor progression was observed. Results AM (+), AM zero, AM (−), and indeterminate were found in 34, 33, 26, and 31 nodules, respectively. The overall agreement rate between MRI and enhanced CT for the diagnosis of AM was 56.8%. The κ coefficient was 0.326 ( p |
| doi_str_mv | 10.1016/j.jhep.2015.07.023 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1735329065</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0168827815005140</els_id><sourcerecordid>1735329065</sourcerecordid><originalsourceid>FETCH-LOGICAL-c551t-3e85d426e6858d7ed2c38217289d7d7294808135428aaff101fde1d1c9a434453</originalsourceid><addsrcrecordid>eNp9UsGO0zAQjRCILQs_wAH5yCVhbMeJIyGkpSwL0kqLxHK2XHvSOqR2sZNF_RW-FkctHDhwsjR-7828eVMULylUFGjzZqiGHR4qBlRU0FbA-KNiRRuAEpqaPi5WGSRLyVp5UTxLaQAADl39tLhgDeOMNd2q-LUenXdGj2RO2M-jx5RI6Mm0Q6I3o57cA5K9jlvniU4p_6Ilm2MubT1OzpCIKXjtDRKXa85vyU837ciNLa_v3pcf7r9ckT5EErV1oY_4Y0Zvjmfp4JdW2YOegsFxnEcdidHROB_2-nnxpNdjwhfn97L49vH6fv2pvL27-by-ui2NEHQqOUpha9ZgI4W0LVpmuGS0ZbKzrW1ZV0uQlIuaSa37Pm-ut0gtNZ2ueV0Lflm8PukeYsjjpUntXVrG0R7DnBRtueCsg2aBshPUxJBSxF4dYrYdj4qCWjJRg1oyUUsmClqVM8mkV2f9ebNH-5fyJ4QMeHsCYHb54DCqZFxeE1oX0UzKBvd__Xf_0M050-94xDSEOfq8P0VVYgrU1-UqlqOgAkDQGvhvolaz4A</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1735329065</pqid></control><display><type>article</type><title>Clinical usefulness of the ablative margin assessed by magnetic resonance imaging with Gd-EOB-DTPA for radiofrequency ablation of hepatocellular carcinoma</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><creator>Koda, Masahiko ; Tokunaga, Shiho ; Okamoto, Toshiaki ; Hodozuka, Masanori ; Miyoshi, Kennichi ; Kishina, Manabu ; Fujise, Yuki ; Kato, Jun ; Matono, Tomomitsu ; Sugihara, Takaaki ; Oyama, Kenji ; Hosho, Keiko ; Okano, Jun-ichi ; Murawaki, Yoshikazu ; Kakite, Suguru ; Yamashita, Eijiro</creator><creatorcontrib>Koda, Masahiko ; Tokunaga, Shiho ; Okamoto, Toshiaki ; Hodozuka, Masanori ; Miyoshi, Kennichi ; Kishina, Manabu ; Fujise, Yuki ; Kato, Jun ; Matono, Tomomitsu ; Sugihara, Takaaki ; Oyama, Kenji ; Hosho, Keiko ; Okano, Jun-ichi ; Murawaki, Yoshikazu ; Kakite, Suguru ; Yamashita, Eijiro</creatorcontrib><description>Background & Aims The aim of this study was to investigate the feasibility of ablative margin (AM) grading by magnetic resonance imaging (MRI) with Gd-EOB-DTPA administered prior to radiofrequency ablation (RFA), and to identify factors for achieving a sufficient AM and predictors for local tumor progression. Methods A total of 124 hepatocellular carcinomas (HCCs) were treated by RFA after Gd-EOB-DTPA administration. MRI and enhanced CT were performed within seven hours and one month after RFA. The AM assessment was categorized using three grades: AM (+), low-intensity area with continuous high-intensity rim; AM zero, low-intensity area with discontinuous high-intensity rim; and AM (−), low-intensity area extends beyond the high-intensity rim. Patients were followed and local tumor progression was observed. Results AM (+), AM zero, AM (−), and indeterminate were found in 34, 33, 26, and 31 nodules, respectively. The overall agreement rate between MRI and enhanced CT for the diagnosis of AM was 56.8%. The κ coefficient was 0.326 ( p <0.001), indicating moderate agreement. Multivariate logistic regression analysis showed that a significant factor for the achievement of AM (+) on MRI was no contiguous vessels. The cumulative local tumor progression rates (0% at 1, 2, and 3 years) in 33 AM (+) nodules were significantly lower than those (3.6%, 11.5%, and 18.3% at 1, 2, and 3 years respectively) in 32 AM zero nodules. A multivariate Cox proportional hazards model identified tumor size as an independent predictor for local tumor progression. Conclusion Gd-EOB-DTPA-MRI enabled an early assessment of RFA effectiveness in the majority of HCC nodules. Local tumor progression was not detected in AM (+) nodules during the follow-up.</description><identifier>ISSN: 0168-8278</identifier><identifier>EISSN: 1600-0641</identifier><identifier>DOI: 10.1016/j.jhep.2015.07.023</identifier><identifier>PMID: 26232269</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Ablative margin ; Aged ; Carcinoma, Hepatocellular - pathology ; Carcinoma, Hepatocellular - surgery ; Catheter Ablation ; Contrast Media ; Disease Progression ; Female ; Gadolinium DTPA ; Gadoxetic acid ; Gastroenterology and Hepatology ; Gd-EOB-DTPA ; Hepatocellular carcinoma ; Humans ; Kaplan-Meier Estimate ; Liver Neoplasms - pathology ; Liver Neoplasms - surgery ; Local tumor progression ; Magnetic Resonance Imaging - methods ; Male ; Middle Aged ; Prognosis ; Radiofrequency ablation ; Tomography, X-Ray Computed</subject><ispartof>Journal of hepatology, 2015-12, Vol.63 (6), p.1360-1367</ispartof><rights>European Association for the Study of the Liver</rights><rights>2015 European Association for the Study of the Liver</rights><rights>Copyright © 2015 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c551t-3e85d426e6858d7ed2c38217289d7d7294808135428aaff101fde1d1c9a434453</citedby><cites>FETCH-LOGICAL-c551t-3e85d426e6858d7ed2c38217289d7d7294808135428aaff101fde1d1c9a434453</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jhep.2015.07.023$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27928,27929,45999</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26232269$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Koda, Masahiko</creatorcontrib><creatorcontrib>Tokunaga, Shiho</creatorcontrib><creatorcontrib>Okamoto, Toshiaki</creatorcontrib><creatorcontrib>Hodozuka, Masanori</creatorcontrib><creatorcontrib>Miyoshi, Kennichi</creatorcontrib><creatorcontrib>Kishina, Manabu</creatorcontrib><creatorcontrib>Fujise, Yuki</creatorcontrib><creatorcontrib>Kato, Jun</creatorcontrib><creatorcontrib>Matono, Tomomitsu</creatorcontrib><creatorcontrib>Sugihara, Takaaki</creatorcontrib><creatorcontrib>Oyama, Kenji</creatorcontrib><creatorcontrib>Hosho, Keiko</creatorcontrib><creatorcontrib>Okano, Jun-ichi</creatorcontrib><creatorcontrib>Murawaki, Yoshikazu</creatorcontrib><creatorcontrib>Kakite, Suguru</creatorcontrib><creatorcontrib>Yamashita, Eijiro</creatorcontrib><title>Clinical usefulness of the ablative margin assessed by magnetic resonance imaging with Gd-EOB-DTPA for radiofrequency ablation of hepatocellular carcinoma</title><title>Journal of hepatology</title><addtitle>J Hepatol</addtitle><description>Background & Aims The aim of this study was to investigate the feasibility of ablative margin (AM) grading by magnetic resonance imaging (MRI) with Gd-EOB-DTPA administered prior to radiofrequency ablation (RFA), and to identify factors for achieving a sufficient AM and predictors for local tumor progression. Methods A total of 124 hepatocellular carcinomas (HCCs) were treated by RFA after Gd-EOB-DTPA administration. MRI and enhanced CT were performed within seven hours and one month after RFA. The AM assessment was categorized using three grades: AM (+), low-intensity area with continuous high-intensity rim; AM zero, low-intensity area with discontinuous high-intensity rim; and AM (−), low-intensity area extends beyond the high-intensity rim. Patients were followed and local tumor progression was observed. Results AM (+), AM zero, AM (−), and indeterminate were found in 34, 33, 26, and 31 nodules, respectively. The overall agreement rate between MRI and enhanced CT for the diagnosis of AM was 56.8%. The κ coefficient was 0.326 ( p <0.001), indicating moderate agreement. Multivariate logistic regression analysis showed that a significant factor for the achievement of AM (+) on MRI was no contiguous vessels. The cumulative local tumor progression rates (0% at 1, 2, and 3 years) in 33 AM (+) nodules were significantly lower than those (3.6%, 11.5%, and 18.3% at 1, 2, and 3 years respectively) in 32 AM zero nodules. A multivariate Cox proportional hazards model identified tumor size as an independent predictor for local tumor progression. Conclusion Gd-EOB-DTPA-MRI enabled an early assessment of RFA effectiveness in the majority of HCC nodules. Local tumor progression was not detected in AM (+) nodules during the follow-up.</description><subject>Ablative margin</subject><subject>Aged</subject><subject>Carcinoma, Hepatocellular - pathology</subject><subject>Carcinoma, Hepatocellular - surgery</subject><subject>Catheter Ablation</subject><subject>Contrast Media</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Gadolinium DTPA</subject><subject>Gadoxetic acid</subject><subject>Gastroenterology and Hepatology</subject><subject>Gd-EOB-DTPA</subject><subject>Hepatocellular carcinoma</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Liver Neoplasms - pathology</subject><subject>Liver Neoplasms - surgery</subject><subject>Local tumor progression</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prognosis</subject><subject>Radiofrequency ablation</subject><subject>Tomography, X-Ray Computed</subject><issn>0168-8278</issn><issn>1600-0641</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UsGO0zAQjRCILQs_wAH5yCVhbMeJIyGkpSwL0kqLxHK2XHvSOqR2sZNF_RW-FkctHDhwsjR-7828eVMULylUFGjzZqiGHR4qBlRU0FbA-KNiRRuAEpqaPi5WGSRLyVp5UTxLaQAADl39tLhgDeOMNd2q-LUenXdGj2RO2M-jx5RI6Mm0Q6I3o57cA5K9jlvniU4p_6Ilm2MubT1OzpCIKXjtDRKXa85vyU837ciNLa_v3pcf7r9ckT5EErV1oY_4Y0Zvjmfp4JdW2YOegsFxnEcdidHROB_2-nnxpNdjwhfn97L49vH6fv2pvL27-by-ui2NEHQqOUpha9ZgI4W0LVpmuGS0ZbKzrW1ZV0uQlIuaSa37Pm-ut0gtNZ2ueV0Lflm8PukeYsjjpUntXVrG0R7DnBRtueCsg2aBshPUxJBSxF4dYrYdj4qCWjJRg1oyUUsmClqVM8mkV2f9ebNH-5fyJ4QMeHsCYHb54DCqZFxeE1oX0UzKBvd__Xf_0M050-94xDSEOfq8P0VVYgrU1-UqlqOgAkDQGvhvolaz4A</recordid><startdate>20151201</startdate><enddate>20151201</enddate><creator>Koda, Masahiko</creator><creator>Tokunaga, Shiho</creator><creator>Okamoto, Toshiaki</creator><creator>Hodozuka, Masanori</creator><creator>Miyoshi, Kennichi</creator><creator>Kishina, Manabu</creator><creator>Fujise, Yuki</creator><creator>Kato, Jun</creator><creator>Matono, Tomomitsu</creator><creator>Sugihara, Takaaki</creator><creator>Oyama, Kenji</creator><creator>Hosho, Keiko</creator><creator>Okano, Jun-ichi</creator><creator>Murawaki, Yoshikazu</creator><creator>Kakite, Suguru</creator><creator>Yamashita, Eijiro</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20151201</creationdate><title>Clinical usefulness of the ablative margin assessed by magnetic resonance imaging with Gd-EOB-DTPA for radiofrequency ablation of hepatocellular carcinoma</title><author>Koda, Masahiko ; Tokunaga, Shiho ; Okamoto, Toshiaki ; Hodozuka, Masanori ; Miyoshi, Kennichi ; Kishina, Manabu ; Fujise, Yuki ; Kato, Jun ; Matono, Tomomitsu ; Sugihara, Takaaki ; Oyama, Kenji ; Hosho, Keiko ; Okano, Jun-ichi ; Murawaki, Yoshikazu ; Kakite, Suguru ; Yamashita, Eijiro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c551t-3e85d426e6858d7ed2c38217289d7d7294808135428aaff101fde1d1c9a434453</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Ablative margin</topic><topic>Aged</topic><topic>Carcinoma, Hepatocellular - pathology</topic><topic>Carcinoma, Hepatocellular - surgery</topic><topic>Catheter Ablation</topic><topic>Contrast Media</topic><topic>Disease Progression</topic><topic>Female</topic><topic>Gadolinium DTPA</topic><topic>Gadoxetic acid</topic><topic>Gastroenterology and Hepatology</topic><topic>Gd-EOB-DTPA</topic><topic>Hepatocellular carcinoma</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Liver Neoplasms - pathology</topic><topic>Liver Neoplasms - surgery</topic><topic>Local tumor progression</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prognosis</topic><topic>Radiofrequency ablation</topic><topic>Tomography, X-Ray Computed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Koda, Masahiko</creatorcontrib><creatorcontrib>Tokunaga, Shiho</creatorcontrib><creatorcontrib>Okamoto, Toshiaki</creatorcontrib><creatorcontrib>Hodozuka, Masanori</creatorcontrib><creatorcontrib>Miyoshi, Kennichi</creatorcontrib><creatorcontrib>Kishina, Manabu</creatorcontrib><creatorcontrib>Fujise, Yuki</creatorcontrib><creatorcontrib>Kato, Jun</creatorcontrib><creatorcontrib>Matono, Tomomitsu</creatorcontrib><creatorcontrib>Sugihara, Takaaki</creatorcontrib><creatorcontrib>Oyama, Kenji</creatorcontrib><creatorcontrib>Hosho, Keiko</creatorcontrib><creatorcontrib>Okano, Jun-ichi</creatorcontrib><creatorcontrib>Murawaki, Yoshikazu</creatorcontrib><creatorcontrib>Kakite, Suguru</creatorcontrib><creatorcontrib>Yamashita, Eijiro</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of hepatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Koda, Masahiko</au><au>Tokunaga, Shiho</au><au>Okamoto, Toshiaki</au><au>Hodozuka, Masanori</au><au>Miyoshi, Kennichi</au><au>Kishina, Manabu</au><au>Fujise, Yuki</au><au>Kato, Jun</au><au>Matono, Tomomitsu</au><au>Sugihara, Takaaki</au><au>Oyama, Kenji</au><au>Hosho, Keiko</au><au>Okano, Jun-ichi</au><au>Murawaki, Yoshikazu</au><au>Kakite, Suguru</au><au>Yamashita, Eijiro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical usefulness of the ablative margin assessed by magnetic resonance imaging with Gd-EOB-DTPA for radiofrequency ablation of hepatocellular carcinoma</atitle><jtitle>Journal of hepatology</jtitle><addtitle>J Hepatol</addtitle><date>2015-12-01</date><risdate>2015</risdate><volume>63</volume><issue>6</issue><spage>1360</spage><epage>1367</epage><pages>1360-1367</pages><issn>0168-8278</issn><eissn>1600-0641</eissn><abstract>Background & Aims The aim of this study was to investigate the feasibility of ablative margin (AM) grading by magnetic resonance imaging (MRI) with Gd-EOB-DTPA administered prior to radiofrequency ablation (RFA), and to identify factors for achieving a sufficient AM and predictors for local tumor progression. Methods A total of 124 hepatocellular carcinomas (HCCs) were treated by RFA after Gd-EOB-DTPA administration. MRI and enhanced CT were performed within seven hours and one month after RFA. The AM assessment was categorized using three grades: AM (+), low-intensity area with continuous high-intensity rim; AM zero, low-intensity area with discontinuous high-intensity rim; and AM (−), low-intensity area extends beyond the high-intensity rim. Patients were followed and local tumor progression was observed. Results AM (+), AM zero, AM (−), and indeterminate were found in 34, 33, 26, and 31 nodules, respectively. The overall agreement rate between MRI and enhanced CT for the diagnosis of AM was 56.8%. The κ coefficient was 0.326 ( p <0.001), indicating moderate agreement. Multivariate logistic regression analysis showed that a significant factor for the achievement of AM (+) on MRI was no contiguous vessels. The cumulative local tumor progression rates (0% at 1, 2, and 3 years) in 33 AM (+) nodules were significantly lower than those (3.6%, 11.5%, and 18.3% at 1, 2, and 3 years respectively) in 32 AM zero nodules. A multivariate Cox proportional hazards model identified tumor size as an independent predictor for local tumor progression. Conclusion Gd-EOB-DTPA-MRI enabled an early assessment of RFA effectiveness in the majority of HCC nodules. Local tumor progression was not detected in AM (+) nodules during the follow-up.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>26232269</pmid><doi>10.1016/j.jhep.2015.07.023</doi><tpages>8</tpages></addata></record> |
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| subjects | Ablative margin Aged Carcinoma, Hepatocellular - pathology Carcinoma, Hepatocellular - surgery Catheter Ablation Contrast Media Disease Progression Female Gadolinium DTPA Gadoxetic acid Gastroenterology and Hepatology Gd-EOB-DTPA Hepatocellular carcinoma Humans Kaplan-Meier Estimate Liver Neoplasms - pathology Liver Neoplasms - surgery Local tumor progression Magnetic Resonance Imaging - methods Male Middle Aged Prognosis Radiofrequency ablation Tomography, X-Ray Computed |
| title | Clinical usefulness of the ablative margin assessed by magnetic resonance imaging with Gd-EOB-DTPA for radiofrequency ablation of hepatocellular carcinoma |
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