Comparison of Chronologic Change in the Size and Contrast-Enhancement of Ablation Zones on CT Images after Irreversible Electroporation and Radiofrequency Ablation

다국어 초록 (Multilingual Abstract)

Objective: To compare short-, mid-, and long-term follow-up ablation zone volume alterations as well as imaging features on contrast-enhanced computed tomography (CT) after irreversible electroporation (IRE) of primary and secondary liver tumors with findings subsequent to radiofrequency ablation (RFA).
Materials and Methods: Volume assessment of 39 ablation zones (19 RFA, 20 IRE) after intervention was performed at four time intervals (day 0 [t1; n = 39], day 1–7 [t2; n = 25], day 8–55 [t3; n = 28], after day 55 [t4; n = 23]) on dual-phase CT. Analysis of peripheral rim enhancement was conducted. Lesion’s volume decrease relative to the volume at t1 was calculated and statistically analyzed with respect to patient’s sex, age, ablation modality (IRE/RFA), and history of platinum-based chemotherapy (PCT).
Results: No influence of patient’s sex or age on ablation volume was detected. The decrease in ablation zones’ volume was significantly larger (p < 0.05 for all time intervals) after IRE (arterial phase, 7.5%; venous phase, 9.7% of initial volume) compared to RFA (arterial phase, 39.6%; venous phase, 45.3% of initial volume). After RFA, significantly smaller decreases in the ablation volumes, in general, were detected in patients treated with PCT in their history (p = 0.004), which was not detected after IRE (p = 0.288). In the arterial phase, peripheral rim enhancement was frequently detected after both IRE and RFA. In the venous phase, rim-enhancement was depicted significantly more often following IRE at t1 and t2 (pt1 = 0.003, pt2 < 0.001).
Conclusion: As per our analysis, ablation zone volume decreased significantly in a more rapid and more profound manner after IRE. Lesion’s remodeling after RFA but not IRE seems to be influenced by PCT, possibly due to the type of cell death induced by the different ablation modalities.

참고문헌 (Reference)

1 Goldberg SN, "Treatment of intrahepatic malignancy with radiofrequency ablation: radiologic-pathologic correlation" 88 : 2452-2463, 2000

2 Morimoto M, "Treatment of hepatocellular carcinoma with radiofrequency ablation: radiologic-histologic correlation during follow-up periods" 35 : 1467-1475, 2002

3 Davalos RV, "Tissue ablation with irreversible electroporation" 33 : 223-231, 2005

4 Maor E, "The effect of irreversible electroporation on blood vessels" 6 : 307-312, 2007

5 Park MH, "Spectrum of CT findings after radiofrequency ablation of hepatic tumors" 28 : 379-390, 2008

6 Golberg A, "Rat liver regeneration following ablation with irreversible electroporation" 4 : e1571-, 2016

7 Keil S, "Radiofrequency ablation of liver metastases-software-assisted evaluation of the ablation zone in MDCT: tumor-free follow-up versus local recurrent disease" 33 : 297-306, 2010

8 Goldberg SN, "Radiofrequency ablation of hepatic tumors: increased tumor destruction with adjuvant liposomal doxorubicin therapy" 179 : 93-101, 2002

9 김수동, "Radiofrequency Ablation of Renal Tumors: Four-Year Follow-Up Results in 47 Patients" 대한영상의학회 13 (13): 625-633, 2012

10 Bertrand J, "Percutaneous hepatic radiofrequency for hepatocellular carcinoma: results and outcome of 46 patients" 7 : 21-27, 2015

11 Siperstein A, "Local recurrence after laparoscopic radiofrequency thermal ablation of hepatic tumors" 7 : 106-113, 2000

12 Li S, "Liver regeneration after radiofrequency ablation versus irreversible electroporation" 95 : 66-68, 2015

13 Rubinsky B, "Irreversible electroporation: a new ablation modality--clinical implications" 6 : 37-48, 2007

14 Lee YJ, "Irreversible electroporation in porcine liver: acute computed tomography appearance of ablation zone with histopathologic correlation" 37 : 154-158, 2013

15 Cheung W, "Irreversible electroporation for unresectable hepatocellular carcinoma: initial experience and review of safety and outcomes" 12 : 233-241, 2013

16 Scheffer HJ, "Irreversible electroporation for nonthermal tumor ablation in the clinical setting: a systematic review of safety and efficacy" 25 : 997-1011, 2014

17 Cheng RG, "Irreversible electroporation can effectively ablate hepatocellular carcinoma to complete pathologic necrosis" 26 : 1184-1188, 2015

18 Dollinger M, "Irreversible electroporation ablation of malignant hepatic tumors: subacute and follow-up CT appearance of ablation zones" 25 : 1589-1594, 2014

19 Christoph Niessen, "Irreversible Electroporation of a Hepatocellular Carcinoma Lesion Adjacent to a Transjugular Intrahepatic Portosystemic Shunt Stent Graft" 대한영상의학회 14 (14): 797-800, 2013

20 Thomson KR, "Investigation of the safety of irreversible electroporation in humans" 22 : 611-621, 2011

21 Lim HK, "Hepatocellular carcinoma treated with percutaneous radiofrequency ablation: evaluation with follow-up multiphase helical CT" 221 : 447-454, 2001

22 Chung DJ, "Contrast enhancement patterns after irreversible electroporation: experimental study of CT perfusion correlated to histopathology in normal porcine liver" 27 : 104-111, 2016

23 Kim YS, "Coagulation necrosis induced by radiofrequency ablation in the liver: histopathologic and radiologic review of usual to extremely rare changes" 31 : 377-390, 2011

24 Martins NM, "Cisplatin induces mitochondrial oxidative stress with resultant energetic metabolism impairment, membrane rigidification and apoptosis in rat liver" 28 : 337-344, 2008

25 Kim HB, "Changes of apoptosis in tumor tissues with time after irreversible electroporation" 435 : 651-656, 2013

26 Taylor RC, "Apoptosis: controlled demolition at the cellular level" 9 : 231-241, 2008

27 Lee EW, "Advanced hepatic ablation technique for creating complete cell death: irreversible electroporation" 255 : 426-433, 2010

28 Fedorov A, "3D Slicer as an image computing platform for the Quantitative Imaging Network" 30 : 1323-1341, 2012