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

<h4>Objectives</h4>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 l...

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Autores principales:	Robert Peter Reimer, Nils Große Hokamp, Julius Niehoff, David Zopfs, Simon Lennartz, Mariam Heidar, Roger Wahba, Dirk Stippel, David Maintz, Daniel Pinto Dos Santos, Christian Wybranski
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/893e65ae9682462b9a2f24450689e56b
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spelling	oai:doaj.org-article:893e65ae9682462b9a2f24450689e56b2021-12-02T20:10:37ZValue of spectral detector computed tomography for the early assessment of technique efficacy after microwave ablation of hepatocellular carcinoma.1932-620310.1371/journal.pone.0252678https://doaj.org/article/893e65ae9682462b9a2f24450689e56b2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0252678https://doaj.org/toc/1932-6203<h4>Objectives</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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). VMI50keV 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 VMI50keV compared to CI (0.92 vs. 0.89), while diagnostic confidence was significantly higher in VMI50keV (p<0.05).<h4>Conclusions</h4>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.Robert Peter ReimerNils Große HokampJulius NiehoffDavid ZopfsSimon LennartzMariam HeidarRoger WahbaDirk StippelDavid MaintzDaniel Pinto Dos SantosChristian WybranskiPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0252678 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Robert Peter Reimer Nils Große Hokamp Julius Niehoff David Zopfs Simon Lennartz Mariam Heidar Roger Wahba Dirk Stippel David Maintz Daniel Pinto Dos Santos Christian Wybranski Value of spectral detector computed tomography for the early assessment of technique efficacy after microwave ablation of hepatocellular carcinoma.
description	<h4>Objectives</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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). VMI50keV 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 VMI50keV compared to CI (0.92 vs. 0.89), while diagnostic confidence was significantly higher in VMI50keV (p<0.05).<h4>Conclusions</h4>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.
format	article
author	Robert Peter Reimer Nils Große Hokamp Julius Niehoff David Zopfs Simon Lennartz Mariam Heidar Roger Wahba Dirk Stippel David Maintz Daniel Pinto Dos Santos Christian Wybranski
author_facet	Robert Peter Reimer Nils Große Hokamp Julius Niehoff David Zopfs Simon Lennartz Mariam Heidar Roger Wahba Dirk Stippel David Maintz Daniel Pinto Dos Santos Christian Wybranski
author_sort	Robert Peter Reimer
title	Value of spectral detector computed tomography for the early assessment of technique efficacy after microwave ablation of hepatocellular carcinoma.
title_short	Value of spectral detector computed tomography for the early assessment of technique efficacy after microwave ablation of hepatocellular carcinoma.
title_full	Value of spectral detector computed tomography for the early assessment of technique efficacy after microwave ablation of hepatocellular carcinoma.
title_fullStr	Value of spectral detector computed tomography for the early assessment of technique efficacy after microwave ablation of hepatocellular carcinoma.
title_full_unstemmed	Value of spectral detector computed tomography for the early assessment of technique efficacy after microwave ablation of hepatocellular carcinoma.
title_sort	value of spectral detector computed tomography for the early assessment of technique efficacy after microwave ablation of hepatocellular carcinoma.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/893e65ae9682462b9a2f24450689e56b
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Value of spectral detector computed tomography for the early assessment of technique efficacy after microwave ablation of hepatocellular carcinoma.

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