Clinical Impact of a Protocol Involving Cone-Beam CT (CBCT), Fusion Imaging and Ablation Volume Prediction in Percutaneous Image-Guided Microwave Ablation in Patients with Hepatocellular Carcinoma Unsuitable for Standard Ultrasound (US) Guidance
Purpose: to evaluate the clinical impact of a protocol for the image-guided percutaneous microwave ablation (MWA) of hepatocellular carcinoma (HCC) that includes cone-beam computed tomography (CBCT), fusion imaging and ablation volume prediction in patients with hepatocellular carcinoma unsuitable f...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/24/7598 |
| _version_ | 1797380534793404416 |
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| author | Pierpaolo Biondetti Anna Maria Ierardi Elena Casiraghi Alessandro Caruso Pasquale Grillo Serena Carriero Carolina Lanza Salvatore Alessio Angileri Angelo Sangiovanni Massimo Iavarone Giuseppe Guzzardi Gianpaolo Carrafiello |
| author_facet | Pierpaolo Biondetti Anna Maria Ierardi Elena Casiraghi Alessandro Caruso Pasquale Grillo Serena Carriero Carolina Lanza Salvatore Alessio Angileri Angelo Sangiovanni Massimo Iavarone Giuseppe Guzzardi Gianpaolo Carrafiello |
| author_sort | Pierpaolo Biondetti |
| collection | DOAJ |
| description | Purpose: to evaluate the clinical impact of a protocol for the image-guided percutaneous microwave ablation (MWA) of hepatocellular carcinoma (HCC) that includes cone-beam computed tomography (CBCT), fusion imaging and ablation volume prediction in patients with hepatocellular carcinoma unsuitable for standard ultrasound (US) guidance. Materials and Methods: this study included all patients with HCC treated with MWA between January 2021 and June 2022 in a tertiary institution. Patients were divided into two groups: Group A, treated following the protocol, and Group B, treated with standard ultrasound (US) guidance. Follow-up images were reviewed to assess residual disease (RD), local tumor progression (LTP) and intrahepatic distant recurrence (IDR). Ablation response at 1 month was also evaluated according to mRECIST. Baseline variables and outcomes were compared between the groups. For 1-month RD, propensity score weighting (PSW) was performed. Results: 80 consecutive patients with 101 HCCs treated with MWA were divided into two groups. Group A had 41 HCCs in 37 patients, and Group B had 60 HCCs in 43 patients. Among all baseline variables, the groups differed regarding their age (mean of 72 years in Group A and 64 years in Group B, respectively), new vs. residual tumor rates (48% Group A vs. 25% Group B, <i>p</i> < 0.05) and number of subcapsular tumors (56.7% Group B vs. 31.7% Group A, <i>p</i> < 0.05) and perivascular tumors (51.7% Group B vs. 17.1% Group A, <i>p</i> < 0.05). The protocol led to repositioning the antenna in 49% of cases. There was a significant difference in 1-month local response between the groups measured as the RD rate and mRECIST outcomes. LTP rates at 3 and 6 months, and IDR rates at 1, 3 and 6 months, showed no significant differences. Among all variables, logistic regression after PSW demonstrated a protective effect of the protocol against 1-month RD. Conclusions: The use of CBCT, fusion imaging and ablation volume prediction during percutaneous MWA of HCCs provided a better 1-month tumor local control. Further studies with a larger population and longer follow-up are needed. |
| first_indexed | 2024-03-08T20:38:41Z |
| format | Article |
| id | doaj.art-3bbf2487283344088311911f223d6bf5 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-08T20:38:41Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-3bbf2487283344088311911f223d6bf52023-12-22T14:17:07ZengMDPI AGJournal of Clinical Medicine2077-03832023-12-011224759810.3390/jcm12247598Clinical Impact of a Protocol Involving Cone-Beam CT (CBCT), Fusion Imaging and Ablation Volume Prediction in Percutaneous Image-Guided Microwave Ablation in Patients with Hepatocellular Carcinoma Unsuitable for Standard Ultrasound (US) GuidancePierpaolo Biondetti0Anna Maria Ierardi1Elena Casiraghi2Alessandro Caruso3Pasquale Grillo4Serena Carriero5Carolina Lanza6Salvatore Alessio Angileri7Angelo Sangiovanni8Massimo Iavarone9Giuseppe Guzzardi10Gianpaolo Carrafiello11Facoltà di Medicina e Chirurgia, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milan, ItalyDepartment of Diagnostic and Interventional Radiology, Foundation IRCCS Cà Granda—Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, ItalyAnacletoLab, Computer Science Department “Giovanni degli Antoni”-DI, Università degli Studi di Milano, 20133 Milan, ItalyFacoltà di Medicina e Chirurgia, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milan, ItalyDepartment of Diagnostic and Interventional Radiology, Foundation IRCCS Cà Granda—Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, ItalyPostgraduate School in Radiodiagnostics, Università degli Studi di Milano, 20122 Milan, ItalyPostgraduate School in Radiodiagnostics, Università degli Studi di Milano, 20122 Milan, ItalyDepartment of Diagnostic and Interventional Radiology, Foundation IRCCS Cà Granda—Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, ItalyDepartment of Gastroenterology and Hepatology, Foundation IRCCS Cà Granda–Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, ItalyFacoltà di Medicina e Chirurgia, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milan, ItalyDepartment of Radiology, Unit of Interventional Radiology, Ospedale Maggiore della Carità, Corso Giuseppe Mazzini 18, 28100 Novara, ItalyFacoltà di Medicina e Chirurgia, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milan, ItalyPurpose: to evaluate the clinical impact of a protocol for the image-guided percutaneous microwave ablation (MWA) of hepatocellular carcinoma (HCC) that includes cone-beam computed tomography (CBCT), fusion imaging and ablation volume prediction in patients with hepatocellular carcinoma unsuitable for standard ultrasound (US) guidance. Materials and Methods: this study included all patients with HCC treated with MWA between January 2021 and June 2022 in a tertiary institution. Patients were divided into two groups: Group A, treated following the protocol, and Group B, treated with standard ultrasound (US) guidance. Follow-up images were reviewed to assess residual disease (RD), local tumor progression (LTP) and intrahepatic distant recurrence (IDR). Ablation response at 1 month was also evaluated according to mRECIST. Baseline variables and outcomes were compared between the groups. For 1-month RD, propensity score weighting (PSW) was performed. Results: 80 consecutive patients with 101 HCCs treated with MWA were divided into two groups. Group A had 41 HCCs in 37 patients, and Group B had 60 HCCs in 43 patients. Among all baseline variables, the groups differed regarding their age (mean of 72 years in Group A and 64 years in Group B, respectively), new vs. residual tumor rates (48% Group A vs. 25% Group B, <i>p</i> < 0.05) and number of subcapsular tumors (56.7% Group B vs. 31.7% Group A, <i>p</i> < 0.05) and perivascular tumors (51.7% Group B vs. 17.1% Group A, <i>p</i> < 0.05). The protocol led to repositioning the antenna in 49% of cases. There was a significant difference in 1-month local response between the groups measured as the RD rate and mRECIST outcomes. LTP rates at 3 and 6 months, and IDR rates at 1, 3 and 6 months, showed no significant differences. Among all variables, logistic regression after PSW demonstrated a protective effect of the protocol against 1-month RD. Conclusions: The use of CBCT, fusion imaging and ablation volume prediction during percutaneous MWA of HCCs provided a better 1-month tumor local control. Further studies with a larger population and longer follow-up are needed.https://www.mdpi.com/2077-0383/12/24/7598cone-beam CT (CBCT)fusion imaginghepatocellular carcinoma (HCC)microwave ablation |
| spellingShingle | Pierpaolo Biondetti Anna Maria Ierardi Elena Casiraghi Alessandro Caruso Pasquale Grillo Serena Carriero Carolina Lanza Salvatore Alessio Angileri Angelo Sangiovanni Massimo Iavarone Giuseppe Guzzardi Gianpaolo Carrafiello Clinical Impact of a Protocol Involving Cone-Beam CT (CBCT), Fusion Imaging and Ablation Volume Prediction in Percutaneous Image-Guided Microwave Ablation in Patients with Hepatocellular Carcinoma Unsuitable for Standard Ultrasound (US) Guidance Journal of Clinical Medicine cone-beam CT (CBCT) fusion imaging hepatocellular carcinoma (HCC) microwave ablation |
| title | Clinical Impact of a Protocol Involving Cone-Beam CT (CBCT), Fusion Imaging and Ablation Volume Prediction in Percutaneous Image-Guided Microwave Ablation in Patients with Hepatocellular Carcinoma Unsuitable for Standard Ultrasound (US) Guidance |
| title_full | Clinical Impact of a Protocol Involving Cone-Beam CT (CBCT), Fusion Imaging and Ablation Volume Prediction in Percutaneous Image-Guided Microwave Ablation in Patients with Hepatocellular Carcinoma Unsuitable for Standard Ultrasound (US) Guidance |
| title_fullStr | Clinical Impact of a Protocol Involving Cone-Beam CT (CBCT), Fusion Imaging and Ablation Volume Prediction in Percutaneous Image-Guided Microwave Ablation in Patients with Hepatocellular Carcinoma Unsuitable for Standard Ultrasound (US) Guidance |
| title_full_unstemmed | Clinical Impact of a Protocol Involving Cone-Beam CT (CBCT), Fusion Imaging and Ablation Volume Prediction in Percutaneous Image-Guided Microwave Ablation in Patients with Hepatocellular Carcinoma Unsuitable for Standard Ultrasound (US) Guidance |
| title_short | Clinical Impact of a Protocol Involving Cone-Beam CT (CBCT), Fusion Imaging and Ablation Volume Prediction in Percutaneous Image-Guided Microwave Ablation in Patients with Hepatocellular Carcinoma Unsuitable for Standard Ultrasound (US) Guidance |
| title_sort | clinical impact of a protocol involving cone beam ct cbct fusion imaging and ablation volume prediction in percutaneous image guided microwave ablation in patients with hepatocellular carcinoma unsuitable for standard ultrasound us guidance |
| topic | cone-beam CT (CBCT) fusion imaging hepatocellular carcinoma (HCC) microwave ablation |
| url | https://www.mdpi.com/2077-0383/12/24/7598 |
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