Abstract

Background & aims

To explore the ability of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid magnetic resonance imaging (EOB-MRI)/ultrasound (US) fusion imaging (FI) to improve the prognosis of radiofrequency ablation (RFA) by ablating the characteristic findings of hepatocellular carcinoma (HCC) in hepatobiliary phase (HBP) imaging.

Methods

We retrospectively recruited 115 solitary HCC lesions with size of (15.9 ± 4.6) mm. They were all treated by RFA and preoperative EOB-MRI. According to the modalities guiding RFA performance, the lesions were grouped into contrast enhanced US (CEUS)/US guidance group and EOB-MRI/US FI guidance group. For the latter group, the ablation scope was set to cover the HBP findings (peritumoral hypointensity and irregular protruding margin). The presence of HBP findings, the modalities guided RFA, the recurrence rate were observed.

Results

After an average follow-up of 377 days, local tumor progression (LTP) and intrahepatic distant recurrence (IDR) were 14.8% and 38.4%, respectively. The lesions having HBP findings exhibited a higher recurrence rate (73.7%) than the lesions without HBP findings (42.9%) (p = 0.002) and a low overall recurrence-free curve using the Kaplan-Meier method (p = 0.038). Using EOB-MRI/US FI as guidance, there was no difference in the recurrence rate between the groups with and without HBP findings (p = 0.799). In lesions with HBP findings, RFA guided by EOB-MRI/US FI (53.8%) produced a lower recurrence rate than CEUS/US (84.0%) (p = 0.045).

Conclusions

The intraprocedurally application of EOB-MRI/US FI to determine ablation scope according to HBP findings is feasible and beneficial for prognosis of RFA.

中文翻译：

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术中EOB-MRI / US融合成像聚焦于肝胆期发现可以帮助减少射频消融后肝细胞癌的复发

摘要

背景与目标

探讨explore乙氧基苄基-二亚乙基三胺五乙酸磁共振成像（EOB-MRI）/超声（US）融合成像（FI）通过消融肝细胞癌（HCC）的特征性结果改善射频消融（RFA）预后的能力）在肝胆期（HBP）成像中。

方法

我们回顾性收集了115例（15.9±4.6）mm大小的HCC病灶。他们都接受了RFA和术前EOB-MRI的治疗。根据指导RFA表现的方式，将病变分为对比增强US（CEUS）/ US指导组和EOB-MRI / US FI指导组。对于后一组，消融范围被设置为覆盖HBP结果（腹膜低血压和不规则的突出边缘）。观察HBP的发现，RFA指导的方式，复发率。

结果

平均随访377天后，局部肿瘤进展（LTP）和肝内远处复发（IDR）分别为14.8％和38.4％。有HBP表现的病灶比无HBP表现的病灶（42.9％）表现出更高的复发率（73.7％）（p  = 0.002），而使用Kaplan-Meier方法的总体无复发曲线低（p  = 0.038）。使用EOB-MRI / US FI作为指导，有和没有HBP发现的组之间的复发率没有差异（p  = 0.799）。在具有HBP发现的病变中，EOB-MRI / US FI指导的RFA（53.8％）的复发率低于CEUS / US（84.0％）（p  = 0.045）。

结论

术中应用EOB-MRI / US FI根据HBP的发现确定消融范围是可行的，对RFA的预后有益。