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Use of Contrast Media During CT-guided Thermal Ablation of Colorectal Liver Metastasis for Procedure Planning is Associated with Improved Immediate Outcomes.
Paolucci, Iwan; Lin, Yuan-Mao; Jones, A Kyle; Brock, Kristy K; Odisio, Bruno C.
  • Paolucci I; Department of Interventional Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX, 77030, USA.
  • Lin YM; Department of Interventional Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX, 77030, USA.
  • Jones AK; Department of Imaging Physics, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
  • Brock KK; Department of Imaging Physics, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
  • Odisio BC; Department of Interventional Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX, 77030, USA. bcodisio@mdanderson.org.
Cardiovasc Intervent Radiol ; 46(3): 327-336, 2023 Mar.
Article in English | MEDLINE | ID: covidwho-2301473
ABSTRACT

PURPOSE:

The aim of this study was to analyze the impact of using intra-procedural pre-ablation contrast-enhanced CT prior to percutaneous thermal ablation (pre-ablation CECT) of colorectal liver metastases (CLM) on local outcomes. MATERIALS AND

METHODS:

This retrospective analysis of a prospectively collected liver ablation registry included 144 consecutive patients (median age 57 years IQR [49, 65], 60% men) who underwent 173 CT-guided ablation sessions for 250 CLM between October 2015 and March 2020. In addition to oncologic outcomes, technical success was retrospectively evaluated using a biomechanical deformable image registration software for 3D-minimal ablative margin (3D-MAM) quantification. Bayesian regression was used to estimate effects of pre-ablation CECT on residual unablated tumor, 3D-MAM, and local tumor progression-free survival (LTPFS).

RESULTS:

Pre-ablation CECT was acquired in 71/173 (41%) sessions. Residual unablated tumor was present in one (0.9%) versus nine tumors (6.6%) ablated with versus without using pre-ablation CECT, respectively (p = 0.024). Pre-ablation CECT use decreased the odds of residual disease on first follow-up by 78% (CI95% [5, 86]) and incomplete ablation (3D-MAM ≤ 0 mm) by 58% (CI95% [13, 122]). The odds ratio for residual unablated tumor for larger CLM was lower when pre-ablation CECT was used (odds ratio 1.0 with pre-ablation CECT vs. 2.52 without). Pre-ablation CECT use was not associated with improvements on LTPFS.

CONCLUSIONS:

Pre-ablation CECT is associated with improved immediate outcomes by significantly reducing the incidence of residual unablated tumor and by mitigating the risk of incomplete ablation for larger CLM. We recommend performing baseline intra-procedural pre-ablation CECT as a standard imaging protocol. LEVEL OF EVIDENCE Level 3 (retrospective cohort study).
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Colorectal Neoplasms / Catheter Ablation / Liver Neoplasms Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Female / Humans / Male / Middle aged Language: English Journal: Cardiovasc Intervent Radiol Year: 2023 Document Type: Article Affiliation country: S00270-022-03333-6

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Colorectal Neoplasms / Catheter Ablation / Liver Neoplasms Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Female / Humans / Male / Middle aged Language: English Journal: Cardiovasc Intervent Radiol Year: 2023 Document Type: Article Affiliation country: S00270-022-03333-6