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Albuquerque J, Lin YM, Paolucci I, O’Connor CS, Tzeng CW, Vauthey JN, Brock KK, Odisio BC. Incidental Ring-hyperenhancing Liver Micronodules at CT Hepatic Arteriography-guided Percutaneous Thermal Ablation of Colorectal Liver Metastases. Radiol Imaging Cancer 2024; 6:e230099. [PMID: 38363196 PMCID: PMC10988328 DOI: 10.1148/rycan.230099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 11/03/2023] [Accepted: 01/02/2024] [Indexed: 02/17/2024]
Abstract
CT during hepatic arteriography (CTHA) is a highly sensitive imaging method for detecting colorectal liver metastases (CLMs), which supports its use during percutaneous thermal liver ablation. In contrast to its high sensitivity, its specificity for incidental small CLMs not detected at preablation cross-sectional imaging is believed to be low given the absence of specific imaging signatures and the common presence of pseudolesions. In this retrospective study of 22 patients (mean age, 55 years ± 10.6 [SD]; 63.6% male, 36.4% female) with CLMs undergoing CTHA-guided microwave percutaneous thermal ablation between November 2017 and October 2022, the authors provided a definition of incidental ring-hyperenhancing liver micronodules (RHLMs) and investigated whether there is a correlation of RHLMs with histologic analysis or intrahepatic tumor progression at imaging follow-up after applying a biomechanical deformable image registration method. The analysis revealed 25 incidental RHLMs in 41.7% (10 of 24) of the CTHA images from the respective guided ablation sessions. Of those, four RHLMs were ablated. Among the remaining 21 RHLMs, 71.4% (15 of 21) were confirmed to be CLM with either histology (n = 3) or imaging follow-up (n = 12). The remaining 28.6% (six of 21) of RHLMs were not observed at follow-up imaging. This suggests that RHLMs at CTHA may be an early indicator of incidental small CLMs. Keywords: Colorectal Neoplasms, Liver, Angiography, CT, Incidental Findings, Ablation Supplemental material is available for this article. © RSNA, 2024.
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Affiliation(s)
- Jessica Albuquerque
- From the Department of Interventional Radiology (J.A., Y.M.L., I.P.,
B.C.O.), Department of Imaging Physics (C.S.O., K.K.B.), and Department of
Surgical Oncology (C.W.T., J.N.V.), The University of Texas MD Anderson Cancer
Center, 1515 Holcombe Blvd, Unit 1484, Houston, TX 77030
| | - Yuan-Mao Lin
- From the Department of Interventional Radiology (J.A., Y.M.L., I.P.,
B.C.O.), Department of Imaging Physics (C.S.O., K.K.B.), and Department of
Surgical Oncology (C.W.T., J.N.V.), The University of Texas MD Anderson Cancer
Center, 1515 Holcombe Blvd, Unit 1484, Houston, TX 77030
| | - Iwan Paolucci
- From the Department of Interventional Radiology (J.A., Y.M.L., I.P.,
B.C.O.), Department of Imaging Physics (C.S.O., K.K.B.), and Department of
Surgical Oncology (C.W.T., J.N.V.), The University of Texas MD Anderson Cancer
Center, 1515 Holcombe Blvd, Unit 1484, Houston, TX 77030
| | - Caleb S. O’Connor
- From the Department of Interventional Radiology (J.A., Y.M.L., I.P.,
B.C.O.), Department of Imaging Physics (C.S.O., K.K.B.), and Department of
Surgical Oncology (C.W.T., J.N.V.), The University of Texas MD Anderson Cancer
Center, 1515 Holcombe Blvd, Unit 1484, Houston, TX 77030
| | - Ching-Wei Tzeng
- From the Department of Interventional Radiology (J.A., Y.M.L., I.P.,
B.C.O.), Department of Imaging Physics (C.S.O., K.K.B.), and Department of
Surgical Oncology (C.W.T., J.N.V.), The University of Texas MD Anderson Cancer
Center, 1515 Holcombe Blvd, Unit 1484, Houston, TX 77030
| | - Jean-Nicolas Vauthey
- From the Department of Interventional Radiology (J.A., Y.M.L., I.P.,
B.C.O.), Department of Imaging Physics (C.S.O., K.K.B.), and Department of
Surgical Oncology (C.W.T., J.N.V.), The University of Texas MD Anderson Cancer
Center, 1515 Holcombe Blvd, Unit 1484, Houston, TX 77030
| | - Kristy K. Brock
- From the Department of Interventional Radiology (J.A., Y.M.L., I.P.,
B.C.O.), Department of Imaging Physics (C.S.O., K.K.B.), and Department of
Surgical Oncology (C.W.T., J.N.V.), The University of Texas MD Anderson Cancer
Center, 1515 Holcombe Blvd, Unit 1484, Houston, TX 77030
| | - Bruno C. Odisio
- From the Department of Interventional Radiology (J.A., Y.M.L., I.P.,
B.C.O.), Department of Imaging Physics (C.S.O., K.K.B.), and Department of
Surgical Oncology (C.W.T., J.N.V.), The University of Texas MD Anderson Cancer
Center, 1515 Holcombe Blvd, Unit 1484, Houston, TX 77030
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Grosse U, Grözinger G, Syha R, Ketelsen D, Partovi S, Nikolaou K, Hoffmann R. Intra-procedural bronchial artery embolization planning: the usefulness of cone-beam CT. Acta Radiol 2019; 60:1438-1444. [PMID: 30897931 DOI: 10.1177/0284185119837931] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Ulrich Grosse
- Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Tuebingen, Germany
| | - Gerd Grözinger
- Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Tuebingen, Germany
| | - Roland Syha
- Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Tuebingen, Germany
| | - Dominik Ketelsen
- Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Tuebingen, Germany
| | - Sasan Partovi
- Department of Radiology, Section of Vascular and Interventional Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Konstantin Nikolaou
- Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Tuebingen, Germany
| | - Rüdiger Hoffmann
- Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Tuebingen, Germany
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