3D Quantitative Ablation Margins for Prediction of Ablation Site Recurrence After Stereotactic Image-Guided Microwave Ablation of Colorectal Liver Metastases: A Multicenter Study

BackgroundThree-dimensional (3D) volumetric ablation margin assessment after thermal ablation of liver tumors using software has been described, but its predictive value on treatment efficacy when accounting for other factors known to correlate ablation site recurrence (ASR) remains unknown.PurposeT...

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Autores principales:	Simeon J. S. Ruiter, Pascale Tinguely, Iwan Paolucci, Jennie Engstrand, Daniel Candinas, Stefan Weber, Robbert J. de Haas, Koert P. de Jong, Jacob Freedman
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	liver neoplasm ablation techniques computer-assisted therapies stereotactic techniques interventional radiology margin assessment Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/415eca50c0314387ae0f9d16019c6997
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spelling	oai:doaj.org-article:415eca50c0314387ae0f9d16019c69972021-11-15T04:29:32Z3D Quantitative Ablation Margins for Prediction of Ablation Site Recurrence After Stereotactic Image-Guided Microwave Ablation of Colorectal Liver Metastases: A Multicenter Study2234-943X10.3389/fonc.2021.757167https://doaj.org/article/415eca50c0314387ae0f9d16019c69972021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fonc.2021.757167/fullhttps://doaj.org/toc/2234-943XBackgroundThree-dimensional (3D) volumetric ablation margin assessment after thermal ablation of liver tumors using software has been described, but its predictive value on treatment efficacy when accounting for other factors known to correlate ablation site recurrence (ASR) remains unknown.PurposeTo investigate 3D quantitative ablation margins (3D-QAMs) as an algorithm to predict ASR within 1 year after stereotactic microwave ablation (SMWA) for colorectal liver metastases (CRLM).Materials and MethodsSixty-five tumors in 47 patients from a prospective multicenter study of patients undergoing SMWA for CRLM were included in this retrospective 3D-QAM analysis. Using a previously developed algorithm, 3D-QAM defined as the distribution of tumor to ablation surface distances was assessed in co-registered pre- and post-ablation CT scans. The discriminatory power and optimal cutoff values for 3D-QAM were assessed using receiver operating characteristic (ROC) curves. Multivariable logistic regression analysis using generalized estimating equations was applied to investigate the impact of various 3D-QAM outputs on 1-year ASR while accounting for other known influencing factors.ResultsTen of the 65 (15.4%) tumors included for 3D-QAM analysis developed ASR. ROC analyses identified i) 3D-QAM <1 mm for >23% of the tumor surface, ii) 3D-QAM <5 mm for >45%, and iii) the minimal ablation margin (MAM) as the 3D-QAM outputs with optimal discriminatory qualities. The multivariable regression model without 3D-QAM yielded tumor diameter and KRAS mutation as 1-year ASR predictors. When adding 3D-QAM, this factor became the main predictor of 1-year ASR [odds ratio (OR) 21.67 (CI 2.48, 165.21) if defined as >23% <1 mm; OR 0.52 (CI 0.29, 0.95) if defined as MAM].Conclusions3D-QAM allows objectifiable and standardized assessment of tumor coverage by the ablation zone after SMWA. Our data shows that 3D-QAM represents the most important factor predicting ASR within 1 year after SMWA of CRLM.Simeon J. S. RuiterPascale TinguelyPascale TinguelyIwan PaolucciJennie EngstrandDaniel CandinasStefan WeberRobbert J. de HaasKoert P. de JongJacob FreedmanFrontiers Media S.A.articleliver neoplasmablation techniquescomputer-assisted therapiesstereotactic techniquesinterventional radiologymargin assessmentNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENFrontiers in Oncology, Vol 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	liver neoplasm ablation techniques computer-assisted therapies stereotactic techniques interventional radiology margin assessment Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	liver neoplasm ablation techniques computer-assisted therapies stereotactic techniques interventional radiology margin assessment Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Simeon J. S. Ruiter Pascale Tinguely Pascale Tinguely Iwan Paolucci Jennie Engstrand Daniel Candinas Stefan Weber Robbert J. de Haas Koert P. de Jong Jacob Freedman 3D Quantitative Ablation Margins for Prediction of Ablation Site Recurrence After Stereotactic Image-Guided Microwave Ablation of Colorectal Liver Metastases: A Multicenter Study
description	BackgroundThree-dimensional (3D) volumetric ablation margin assessment after thermal ablation of liver tumors using software has been described, but its predictive value on treatment efficacy when accounting for other factors known to correlate ablation site recurrence (ASR) remains unknown.PurposeTo investigate 3D quantitative ablation margins (3D-QAMs) as an algorithm to predict ASR within 1 year after stereotactic microwave ablation (SMWA) for colorectal liver metastases (CRLM).Materials and MethodsSixty-five tumors in 47 patients from a prospective multicenter study of patients undergoing SMWA for CRLM were included in this retrospective 3D-QAM analysis. Using a previously developed algorithm, 3D-QAM defined as the distribution of tumor to ablation surface distances was assessed in co-registered pre- and post-ablation CT scans. The discriminatory power and optimal cutoff values for 3D-QAM were assessed using receiver operating characteristic (ROC) curves. Multivariable logistic regression analysis using generalized estimating equations was applied to investigate the impact of various 3D-QAM outputs on 1-year ASR while accounting for other known influencing factors.ResultsTen of the 65 (15.4%) tumors included for 3D-QAM analysis developed ASR. ROC analyses identified i) 3D-QAM <1 mm for >23% of the tumor surface, ii) 3D-QAM <5 mm for >45%, and iii) the minimal ablation margin (MAM) as the 3D-QAM outputs with optimal discriminatory qualities. The multivariable regression model without 3D-QAM yielded tumor diameter and KRAS mutation as 1-year ASR predictors. When adding 3D-QAM, this factor became the main predictor of 1-year ASR [odds ratio (OR) 21.67 (CI 2.48, 165.21) if defined as >23% <1 mm; OR 0.52 (CI 0.29, 0.95) if defined as MAM].Conclusions3D-QAM allows objectifiable and standardized assessment of tumor coverage by the ablation zone after SMWA. Our data shows that 3D-QAM represents the most important factor predicting ASR within 1 year after SMWA of CRLM.
format	article
author	Simeon J. S. Ruiter Pascale Tinguely Pascale Tinguely Iwan Paolucci Jennie Engstrand Daniel Candinas Stefan Weber Robbert J. de Haas Koert P. de Jong Jacob Freedman
author_facet	Simeon J. S. Ruiter Pascale Tinguely Pascale Tinguely Iwan Paolucci Jennie Engstrand Daniel Candinas Stefan Weber Robbert J. de Haas Koert P. de Jong Jacob Freedman
author_sort	Simeon J. S. Ruiter
title	3D Quantitative Ablation Margins for Prediction of Ablation Site Recurrence After Stereotactic Image-Guided Microwave Ablation of Colorectal Liver Metastases: A Multicenter Study
title_short	3D Quantitative Ablation Margins for Prediction of Ablation Site Recurrence After Stereotactic Image-Guided Microwave Ablation of Colorectal Liver Metastases: A Multicenter Study
title_full	3D Quantitative Ablation Margins for Prediction of Ablation Site Recurrence After Stereotactic Image-Guided Microwave Ablation of Colorectal Liver Metastases: A Multicenter Study
title_fullStr	3D Quantitative Ablation Margins for Prediction of Ablation Site Recurrence After Stereotactic Image-Guided Microwave Ablation of Colorectal Liver Metastases: A Multicenter Study
title_full_unstemmed	3D Quantitative Ablation Margins for Prediction of Ablation Site Recurrence After Stereotactic Image-Guided Microwave Ablation of Colorectal Liver Metastases: A Multicenter Study
title_sort	3d quantitative ablation margins for prediction of ablation site recurrence after stereotactic image-guided microwave ablation of colorectal liver metastases: a multicenter study
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/415eca50c0314387ae0f9d16019c6997
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3D Quantitative Ablation Margins for Prediction of Ablation Site Recurrence After Stereotactic Image-Guided Microwave Ablation of Colorectal Liver Metastases: A Multicenter Study

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