Detection of Ablation Boundaries Using Different MR Sequences in a Swine Liver Model

Cardiovasc Intervent Radiol. 2022 Jul;45(7):1010-1018. doi: 10.1007/s00270-022-03143-w. Epub 2022 Apr 21.

Abstract

Purpose: To determine the magnetic resonance (MR) sequences best suited for the assessment of ablation zones after radiofrequency ablation (RFA).

Methods: Three percutaneous MR-guided RFA of the liver were performed on three swine. Four pre-contrast and two hepatobiliary post-contrast sequences were obtained after ablation. Tissue samples were extracted and stained for nicotinamide adenine dinucleotide diaphorase hydride (NADH) and with hematoxylin and eosin. Post-ablation MR images and NADH slides were segmented to determine the total ablation zone, their Dice similarity coefficient (DSC), and the contrast-to-noise ratio (CNR) of the visible ablation boundary to normal liver tissue.

Results: Two distinct layers were combined to determine the ablation zone: an inner layer of coagulation necrosis and an outer layer defined as the peripheral transition zone. Corresponding zones could be found in the MR images as well. Compared to histology, the total area of the MR ablation zone was significantly smaller on the pre-contrast T1 images (p < 0.01) and significantly larger with T2 turbo spin-echo (p = 0.025). No significant difference in size of the ablation zone depiction could be found between histology, post-contrast T1 volumetric interpolated breath-hold examination (VIBE), and post-contrast T1 3D Turboflash (TFL) as well as T2 SPACE images. All sequences but the pre-contrast T1 VIBE sequence showed a DSC above 80% and a high CNR.

Conclusions: Post-contrast T1 3DTFL performs best when assessing ablation zones after RFA. Since the sequence requires a long acquisition time, T1 VIBE post-contrast offers the best compromise between acquisition time and estimation accuracy.

Keywords: Interventional oncology; MRI; MRI intervention; RF-ablation; Thermal ablation.

MeSH terms

  • Animals
  • Catheter Ablation* / methods
  • Humans
  • Liver / diagnostic imaging
  • Liver / pathology
  • Liver / surgery
  • Magnetic Resonance Imaging / methods
  • Magnetic Resonance Spectroscopy
  • NAD*
  • Swine

Substances

  • NAD