Quantitative Volumetric Assessment of Ablative Margins in Hepatocellular Carcinoma: Predicting Local Tumor Progression Using Nonrigid Registration Software

P. Hendriks, W. A. Noortman, T. R. Baetens, A. R. Van Erkel, C. S.P. Van Rijswijk, R. W. Van Der Meer, M. J. Coenraad, L. F. De Geus-Oei, C. H. Slump, M. C. Burgmans

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Abstract

Purpose. After radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC), pre-and postinterventional contrast-enhanced CT (CECT) images are usually qualitatively interpreted to determine technical success, by eyeballing. The objective of this study was to evaluate the feasibility of quantitative assessment, using a nonrigid CT-CT coregistration algorithm. Materials and Methods. 25 patients treated with RFA for HCC between 2009 and 2014 were retrospectively included. Semiautomated coregistration of pre-and posttreatment CECT was performed independently by two radiologists. In scans with a reliable registration, the tumor and ablation area were delineated to identify the side and size of narrowest RFA margin. In addition, qualitative assessment was performed independently by two other radiologists to determine technical success and the anatomical side and size of narrowest margin. Interobserver agreement rates were determined for both methods, and the outcomes were compared with occurrence of local tumor progression (LTP). Results. CT-CT coregistration was technically feasible in 18/25 patients with almost perfect interobserver agreement for quantitative analysis (= 0.88). The interobserver agreement for qualitative RFA margin analysis was = 0.64. Using quantitative assessment, negative ablative margins were found in 12/18 patients, with LTP occurring in 8 of these patients. In the remaining 6 patients, quantitative analysis demonstrated complete tumor ablation and no LTP occurred. Conclusion. Feasibility of quantitative RFA margin assessment using nonrigid coregistration of pre-and postablation CT is limited, but appears to be a valuable tool in predicting LTP in HCC patients (p=0.013).

Original languageEnglish
Article number4049287
Number of pages8
JournalJournal of oncology
Volume2019
DOIs
Publication statusPublished - 19 Sep 2019

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Hepatocellular Carcinoma
Software
Neoplasms
Radiologists

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Hendriks, P., Noortman, W. A., Baetens, T. R., Van Erkel, A. R., Van Rijswijk, C. S. P., Van Der Meer, R. W., ... Burgmans, M. C. (2019). Quantitative Volumetric Assessment of Ablative Margins in Hepatocellular Carcinoma: Predicting Local Tumor Progression Using Nonrigid Registration Software. Journal of oncology, 2019, [4049287]. https://doi.org/10.1155/2019/4049287
Hendriks, P. ; Noortman, W. A. ; Baetens, T. R. ; Van Erkel, A. R. ; Van Rijswijk, C. S.P. ; Van Der Meer, R. W. ; Coenraad, M. J. ; De Geus-Oei, L. F. ; Slump, C. H. ; Burgmans, M. C. / Quantitative Volumetric Assessment of Ablative Margins in Hepatocellular Carcinoma : Predicting Local Tumor Progression Using Nonrigid Registration Software. In: Journal of oncology. 2019 ; Vol. 2019.
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title = "Quantitative Volumetric Assessment of Ablative Margins in Hepatocellular Carcinoma: Predicting Local Tumor Progression Using Nonrigid Registration Software",
abstract = "Purpose. After radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC), pre-and postinterventional contrast-enhanced CT (CECT) images are usually qualitatively interpreted to determine technical success, by eyeballing. The objective of this study was to evaluate the feasibility of quantitative assessment, using a nonrigid CT-CT coregistration algorithm. Materials and Methods. 25 patients treated with RFA for HCC between 2009 and 2014 were retrospectively included. Semiautomated coregistration of pre-and posttreatment CECT was performed independently by two radiologists. In scans with a reliable registration, the tumor and ablation area were delineated to identify the side and size of narrowest RFA margin. In addition, qualitative assessment was performed independently by two other radiologists to determine technical success and the anatomical side and size of narrowest margin. Interobserver agreement rates were determined for both methods, and the outcomes were compared with occurrence of local tumor progression (LTP). Results. CT-CT coregistration was technically feasible in 18/25 patients with almost perfect interobserver agreement for quantitative analysis (= 0.88). The interobserver agreement for qualitative RFA margin analysis was = 0.64. Using quantitative assessment, negative ablative margins were found in 12/18 patients, with LTP occurring in 8 of these patients. In the remaining 6 patients, quantitative analysis demonstrated complete tumor ablation and no LTP occurred. Conclusion. Feasibility of quantitative RFA margin assessment using nonrigid coregistration of pre-and postablation CT is limited, but appears to be a valuable tool in predicting LTP in HCC patients (p=0.013).",
author = "P. Hendriks and Noortman, {W. A.} and Baetens, {T. R.} and {Van Erkel}, {A. R.} and {Van Rijswijk}, {C. S.P.} and {Van Der Meer}, {R. W.} and Coenraad, {M. J.} and {De Geus-Oei}, {L. F.} and Slump, {C. H.} and Burgmans, {M. C.}",
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Quantitative Volumetric Assessment of Ablative Margins in Hepatocellular Carcinoma : Predicting Local Tumor Progression Using Nonrigid Registration Software. / Hendriks, P.; Noortman, W. A.; Baetens, T. R.; Van Erkel, A. R.; Van Rijswijk, C. S.P.; Van Der Meer, R. W.; Coenraad, M. J.; De Geus-Oei, L. F.; Slump, C. H.; Burgmans, M. C.

In: Journal of oncology, Vol. 2019, 4049287, 19.09.2019.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Quantitative Volumetric Assessment of Ablative Margins in Hepatocellular Carcinoma

T2 - Predicting Local Tumor Progression Using Nonrigid Registration Software

AU - Hendriks, P.

AU - Noortman, W. A.

AU - Baetens, T. R.

AU - Van Erkel, A. R.

AU - Van Rijswijk, C. S.P.

AU - Van Der Meer, R. W.

AU - Coenraad, M. J.

AU - De Geus-Oei, L. F.

AU - Slump, C. H.

AU - Burgmans, M. C.

PY - 2019/9/19

Y1 - 2019/9/19

N2 - Purpose. After radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC), pre-and postinterventional contrast-enhanced CT (CECT) images are usually qualitatively interpreted to determine technical success, by eyeballing. The objective of this study was to evaluate the feasibility of quantitative assessment, using a nonrigid CT-CT coregistration algorithm. Materials and Methods. 25 patients treated with RFA for HCC between 2009 and 2014 were retrospectively included. Semiautomated coregistration of pre-and posttreatment CECT was performed independently by two radiologists. In scans with a reliable registration, the tumor and ablation area were delineated to identify the side and size of narrowest RFA margin. In addition, qualitative assessment was performed independently by two other radiologists to determine technical success and the anatomical side and size of narrowest margin. Interobserver agreement rates were determined for both methods, and the outcomes were compared with occurrence of local tumor progression (LTP). Results. CT-CT coregistration was technically feasible in 18/25 patients with almost perfect interobserver agreement for quantitative analysis (= 0.88). The interobserver agreement for qualitative RFA margin analysis was = 0.64. Using quantitative assessment, negative ablative margins were found in 12/18 patients, with LTP occurring in 8 of these patients. In the remaining 6 patients, quantitative analysis demonstrated complete tumor ablation and no LTP occurred. Conclusion. Feasibility of quantitative RFA margin assessment using nonrigid coregistration of pre-and postablation CT is limited, but appears to be a valuable tool in predicting LTP in HCC patients (p=0.013).

AB - Purpose. After radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC), pre-and postinterventional contrast-enhanced CT (CECT) images are usually qualitatively interpreted to determine technical success, by eyeballing. The objective of this study was to evaluate the feasibility of quantitative assessment, using a nonrigid CT-CT coregistration algorithm. Materials and Methods. 25 patients treated with RFA for HCC between 2009 and 2014 were retrospectively included. Semiautomated coregistration of pre-and posttreatment CECT was performed independently by two radiologists. In scans with a reliable registration, the tumor and ablation area were delineated to identify the side and size of narrowest RFA margin. In addition, qualitative assessment was performed independently by two other radiologists to determine technical success and the anatomical side and size of narrowest margin. Interobserver agreement rates were determined for both methods, and the outcomes were compared with occurrence of local tumor progression (LTP). Results. CT-CT coregistration was technically feasible in 18/25 patients with almost perfect interobserver agreement for quantitative analysis (= 0.88). The interobserver agreement for qualitative RFA margin analysis was = 0.64. Using quantitative assessment, negative ablative margins were found in 12/18 patients, with LTP occurring in 8 of these patients. In the remaining 6 patients, quantitative analysis demonstrated complete tumor ablation and no LTP occurred. Conclusion. Feasibility of quantitative RFA margin assessment using nonrigid coregistration of pre-and postablation CT is limited, but appears to be a valuable tool in predicting LTP in HCC patients (p=0.013).

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U2 - 10.1155/2019/4049287

DO - 10.1155/2019/4049287

M3 - Article

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JO - Journal of oncology

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