The use of PET-MRI in the follow-up after radiofrequency- and microwave ablation of colorectal liver metastases

BMC Medical Imaging

Study Protocol

Colin Sietses¹  Hermien WH Schreurs²  Sybren Meijer³  Geert Kazemier³  Petrousjka MP van den Tol³  Karin Nielsen³  Jan-Hein TM van Waesberghe⁴  Indra C Pieters⁴  Emile FI Comans⁴  Hester J Scheffer⁴  Otto S Hoekstra⁴  Daniela E Oprea-Lager⁴  Martijn R Meijerink⁴  Aukje AJM van Tilborg⁴ 

[1] Department of Surgery, Gelderse Vallei, Willy Brandtlaan 10, 6716, RP Ede, The Netherlands;Department of Surgery, Medical Center Alkmaar, Postbus 501, 1800 AM, Alkmaar, The Netherlands;Department of Surgery, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands;Radiology & Nuclear Medicine, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands;

关键词: Radiofrequency ablation;    Liver neoplasms/secondary;    Neoplasm recurrence;    Local;    Liver neoplasms/surgery;    FDG-PET;    PET-MRI;    Magnetic resonance imaging/methods;    Microwave ablation;   

DOI  :  10.1186/1471-2342-14-27

 received in 2014-03-23, accepted in 2014-08-04,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundThermal ablation of colorectal liver metastases (CRLM) may result in local progression, which generally appear within a year of treatment. As the timely diagnosis of this progression allows potentially curative local treatment, an optimal follow-up imaging strategy is essential. PET-MRI is a one potential imaging modality, combining the advantages of PET and MRI. The aim of this study is evaluate fluorine-18 deoxyglucose positron emission tomography (FDG) PET-MRI as a modality for detection of local tumor progression during the first year following thermal ablation, as compared to the current standard, FDG PET-CT. The ability of FDG PET-MRI to detect new intrahepatic lesions, and the extent to which FDG PET-MRI alters clinical management, inter-observer variability and patient preference will also be included as secondary outcomes.Methods/DesignTwenty patients undergoing treatment with radiofrequency or microwave ablation for (recurrent) CRLM will be included in this prospective trial. During the first year of follow-up, patients will be scanned at the VU University Medical Center at 3-monthly intervals using a 4-phase liver CT, FDG PET-CT and FDG PET-MRI. Patients treated with chemotherapy <6 weeks prior to scanning or with a contra-indication for MRI will be excluded. MRI will be performed using both whole body imaging (mDixon) and dedicated liver sequences, including diffusion-weighted imaging, T1 in-phase and opposed-phase, T2 and dynamic contrast-enhanced imaging. The results of all modalities will be scored by 4 individual reviewers and inter-observer agreement will be determined. The reference standard will be histology or clinical follow-up. A questionnaire regarding patients’ experience with both modalities will also be completed at the end of the follow-up year.DiscussionImproved treatment options for local site recurrences following CRLM ablation mean that accurate post-ablation staging is becoming increasingly important. The combination of the sensitivity of MRI as a detection method for small intrahepatic lesions with the ability of FDG PET to visualize enhanced metabolism at the ablation site suggests that FDG PET-MRI could potentially improve the accuracy of (early) detection of progressive disease, and thus allow swifter and more effective decision-making regarding appropriate treatment.Trial registrationTrial registration number: NCT01895673

【 授权许可】

Unknown   
© Nielsen et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.