title: Assessment of ablative margin after radiofrequency ablation for hepatocellular carcinoma; comparison between magnetic resonance imaging with ferucarbotran and enhanced CT with iodized oil deposition.
abstract: OBJECTIVE
  Our aim was to investigate whether magnetic resonance imaging (MRI) with ferucarbotran administered prior to radiofrequency ablation could accurately assess ablative margin when compared with enhanced computed tomography (CT) with iodized oil marking.
  
  
  METHODS
  We enrolled 27 patients with 32 hepatocellular carcinomas in which iodized oil deposits were visible throughout the nodule after transcatheter arterial chemoembolization. For these nodules, radiofrequency ablation was performed after ferucarbotran administration. We then performed T2-weighted MRI after 1 week and enhanced CT after 1 month. T2-weighted MRI demonstrated the ablative margin as a low-intensity rim. We classified the margin into three grades; margin (+): high-intensity area with a continuous low-intensity rim; margin zero: high-intensity area with a discontinuous low-intensity rim; and margin (-): high-intensity area extending beyond the low-intensity rim.
  
  
  RESULTS
  In 28 (86%) of 32 nodules, there was agreement between MRI and CT. The overall agreement between for the two modalities in the assessment of ablative margin was good (κ=0.759, 95% confidence interval: 0.480-1.000, p<0.001). In four nodules, ablative margins on MRI were underestimated by one grade compared with CT.
  
  
  CONCLUSIONS
  MRI using ferucarbotran is less invasive and allows earlier assessment than CT. The MRI technique performed similarly to enhanced CT with iodized oil marking in evaluating the ablative margin after radiofrequency ablation.
authors: Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Tottori University School of Medicine, 36-1 Nishicho, Yonago 683-8504, Japan. masakoda@grape.med.tottori-u.ac.jp
authors: Masahiko
authors: M
authors: Koda
authors: Shiho
authors: S
authors: Tokunaga
authors: Yuki
authors: Y
authors: Fujise
authors: Jun
authors: J
authors: Kato
authors: Tomomitsu
authors: T
authors: Matono
authors: Takaaki
authors: T
authors: Sugihara
authors: Takakazu
authors: T
authors: Nagahara
authors: Masaru
authors: M
authors: Ueki
authors: Yoshikazu
authors: Y
authors: Murawaki
authors: Suguru
authors: S
authors: Kakite
authors: Eijiro
authors: E
authors: Yamashita
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D016461:Chemoembolization, Therapeutic / Q000379:methods; D003287:Contrast Media; D003911:Dextrans; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007459:Iodized Oil / Q000008:administration & dosage*; D007479:Iopamidol; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D058185:Magnetite Nanoparticles; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D036542:Tomography, Spiral Computed / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D003911:Dextrans; D058185:Magnetite Nanoparticles; D015251:Epirubicin; D007459:Iodized Oil; C065507:ferumoxides; D007479:Iopamidol