Abstract
BackgroundRadiofrequency ablation (RFA) is one of the most promising non-surgical treatments for hepatic tumors. The assessment of the therapeutic efficacy of RFA is usually obtained by visual comparison of pre- and post-treatment CT images, but no numerical quantification is performed.MethodsIn this work, a novel method aiming at providing a more objective tool for the evaluation of RFA coverage is described. Image registration and segmentation techniques were applied to enable the visualization of the tumor and the corresponding post-RFA necrosis in the same framework. In addition, a set of numerical indexes describing tumor/necrosis overlap and their mutual position were computed.ResultsAfter validation of segmentation step, the method was applied on a dataset composed by 10 tumors, suspected not to be completed treated. Numerical indexes showed that only two tumors were totally treated and the percentage of a residual tumor was in the range of 5.12%-35.92%.ConclusionsThis work represents a first attempt to obtain a quantitative tool aimed to assess the accuracy of RFA treatment. The possibility to visualize the tumor and the correspondent post-RFA necrosis in the same framework and the definition of some synthetic numerical indexes could help clinicians in ameliorating RFA treatment.
Highlights
Radiofrequency ablation (RFA) is one of the most promising non-surgical treatments for hepatic tumors
We introduced a set of numerical indexes measuring overlap between tumor and RFA induced necrosis and their reciprocal position after realignment and segmentation of pre- and post-RFA CT images
Percentage Match (PM) and P+ mean values are very close to the optimum point on the top-right (PM > 90% and P + > 94%) and, in addition, the necrosis PM mean value is lower than the tumors one
Summary
Radiofrequency ablation (RFA) is one of the most promising non-surgical treatments for hepatic tumors. The assessment of the therapeutic efficacy of RFA is usually obtained by visual comparison of pre- and post-treatment CT images, but no numerical quantification is performed. Image-guided radiofrequency ablation is a powerful locoregional technique for the treatment of the non resectable primary and metastatic hepatic malignancies and a curative alternative to surgery in circumscribded tumors (inferior to 3 cm in diameter) [1]. It would be fundamental to assess the overlap between the tumor and the RFA necrotized tissues after the treatment. The two major indicators of tumor necrotization and treatment efficacy are parenchyma changes seen on post-treatment. The obstacles are: i) small contrast between necrosis and residual tumor, ii) inflammation process due to coagulative effects, iii) possible blood effusions [4]
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