SIR 2024
Interventional Oncology
Sadeer Alzubaidi, MD
Interventional Radiologist
Mayo Clinic
Financial relationships: Full list of relationships is listed on the CME information page.
Nami Azar, MD
Associate Professor
University Hospitals Case Medical Center
Disclosure information not submitted.
Thomas Atwell, MD (he/him/his)
Professor of Radiology
Mayo Clinic Rochester
Disclosure information not submitted.
Nishita Kothary, MD
Professor of Radiology
Stanford University School of Medicine
Disclosure information not submitted.
Raul N. Uppot, MD
Associate Professor
Massachusetts General Hospital
Financial relationships: Full list of relationships is listed on the CME information page.
An increase of liver microwave ablation (MWA) volume within 24 hours post-procedure due to delayed tissue injury was previously reported. The current study aims to demonstrate the effectiveness of an artificial intelligence-based image analysis software (SW) for estimation of the ablation zone from intra-procedural ultrasound as compared to 24-hour post-procedure contrast-enhanced computed tomography (CECT).
Materials and Methods:
A total of 50 patients with 51 liver tumors undergoing real-time ultrasound monitored MWA with single antenna were included. Median age was 67.5 years (range 40-81) with 74% male patients (n=37). 65% were naïve HCC tumors (n=33) and the remaining (n=18) were various metastases. Median tumor diameter was 1.7 cm (range 1.0-3.0). Ultrasound cine clips were recorded during the procedure and analyzed by the SW to create an ablation zone map. Two CECT scans with similar acquisition parameters were acquired immediately (T=0) and 24hours post-procedure (T=24). A team of three interventional radiologists approved the ablation zone segmentation on each CECT and the location of the CECT oblique plane corresponding to the intra-procedure ultrasound recording. The T=0 ablation zone and the SW ablation zone map were compared to the T=24 ablation zone on the 2D oblique plane using Dice Coefficient, Sensitivity and Precision (PPV).
Results:
The average calculated Dice between T=0 vs. T=24 ablation zones were 76.8% (range 10-88%). The average Dice between the SW ablation zone map and the T=24 ablation zone was 85.5% (range 56-94%). The sensitivity of the SW map was found to be higher than that of the T=0 CECT, with 81.6% versus 63.7%, compared to the T=24 ablation zone. The average PPV value of the SW Map was 91.2% when compared to the T=24 ablation zone. Statistical analysis showed that the mean Dice for the SW vs. T=24 CECT was significantly higher than T=0 CECT vs. T=24 CECT (p-value < < 0.05).
Conclusion: We demonstrate that the proposed SW can accurately estimate the ablation zone from intra-procedural ultrasound as would be visualized on T=24 CECT. This may provide the physician with real-time information regarding the final ablation zone extent.