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A tumor map generated from three-dimensional visualization of image fusion for the assessment of microwave ablation of hepatocellular carcinoma: a preliminary study

Authors An C, Li X, Liang P, Yu J, Cheng Z, Han Z, Liu F, Dong L

Received 20 November 2018

Accepted for publication 23 January 2019

Published 15 February 2019 Volume 2019:11 Pages 1569—1578

DOI https://doi.org/10.2147/CMAR.S195354

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 4

Editor who approved publication: Dr Antonella D'Anneo


Chao An,* Xin Li,* Ping Liang, Jie Yu, Zhigang Cheng, Zhiyu Han, Fangyi Liu, Linan Dong

Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, 100853, China

*These authors contributed equally to this work

Purpose: This study aimed to investigate the clinical value of a tumor map for assessing the ablative effect after ultrasound-guided percutaneous microwave ablation (US-PMWA) for hepatocellular carcinoma (HCC).
Methods: The medical records of 68 patients (49 male and 19 female, 59.9±12.7 years) with HCC who underwent US-PMWA from May 2013 to May 2017 were reviewed. A tumor map was generated from the fusion of three-dimensional (3D) visualization images based on the preoperative target tumor and postoperative ablation area, to evaluate whether the ablation area covering the tumor has reached a 5 mm ablative margin (AM). The lesions were divided into two groups according to the tumor maps: group A (failed to achieve AM) and group B (achieved AM). The cumulative local tumor progression (LTP) rates of both groups were statistically analyzed using the log-rank test.
Results: Success rate of tumor map generation was 100% (68/68), and no residual tumors were found. MWA-related 3D images, which included target tumor volume, ablation area volume, and residual liver ratio, were compared between groups A and B (P=0.295, P=0.772, and P=0.527, respectively). Technique effectiveness rate (91.7% vs 100%) was achieved in the two groups, showing no significant statistical differences (P=0.672). The 3-, 6-, 9-, and 12-month LTP rate was 8.3%, 16.7%, 20.8%, and 34%, respectively, for group A and 0%, 2.8%, 2.8%, and 2.8%, respectively, for group B, showing significant statistical differences (P<0.001) between the two groups.
Conclusion: The novel technology of tumor map generated from 3D visualization of image fusion is feasible and useful in evaluating the ablative effect of US-PMWA for HCC.

Keywords: three-dimensional visualization, tumor map, image fusion, microwave ablation, hepatocellular carcinoma

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