title: Ablative margin states by magnetic resonance imaging with ferucarbotran in radiofrequency ablation for hepatocellular carcinoma can predict local tumor progression.
abstract: BACKGROUND
  Our aim was to determine how well ablative margin (AM) grading assessed by magnetic resonance imaging (MRI) with ferucarbotran administered prior to radiofrequency ablation (RFA) predicts local tumor progression in comparison with enhanced computed tomography (CT).
  
  
  METHODS
  101 hepatocellular carcinomas were treated by RFA after ferucarbotran administration. We performed T2*-weighted MRI after 1 week and enhanced CT after 1 month. The assessment was categorized in three grades: AM(+): high-intensity area with continuous low-intensity rim; AM zero: high-intensity area with discontinuous low-intensity rim; and AM(-): high-intensity area extending beyond the low-intensity rim.
  
  
  RESULTS
  AM(+), AM zero, AM(-) and indeterminable were found in 47, 36, 8 and 10 nodules, respectively. The overall agreement rate between MRI and enhanced CT for the diagnosis of AM was 71.3%. The κ coefficient was 0.523 (p < 0.001), indicating moderate agreement. Multivariate logistic regression showed that a significant factor for the achievement of AM(+) on MRI was only segment location (odds ratio 5.9, non-segment 4 + 8 vs. segment 4 + 8). The cumulative local tumor progression rates (4.4, 7.6, and 7.6% in 1, 2, and 3 years) in 47 AM(+) nodules were significantly lower than those (13.9, 33.4, and 41.8% in 1, 2, and 3 years) in 36 AM zero nodules. A multivariate Cox proportional hazards model identified contiguous vessels (odds ratio 12.0) and AM(+) on MRI (odds ratio 0.19) as independent factors for local tumor progression.
  
  
  CONCLUSIONS
  AM assessment by MRI using ferucarbotran can predict local tumor progression after RFA and enable early and less invasive diagnosis.
authors: Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Tottori University, Yonago, 683-8504, Japan, masakoda@grape.med.tottori-u.ac.jp.
authors: Masahiko
authors: M
authors: Koda
authors: Shiho
authors: S
authors: Tokunaga
authors: Kennichi
authors: K
authors: Miyoshi
authors: Manabu
authors: M
authors: Kishina
authors: Yuki
authors: Y
authors: Fujise
authors: Jun
authors: J
authors: Kato
authors: Tomomitsu
authors: T
authors: Matono
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 / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D003287:Contrast Media; D003911:Dextrans; D018450:Disease Progression; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods; D058185:Magnetite Nanoparticles; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D018365:Neoplasm, Residual; D011182:Postoperative Care / Q000379:methods; D011379:Prognosis; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media; D003911:Dextrans; D058185:Magnetite Nanoparticles; C065507:ferumoxides