title: Percutaneous imaging-guided cryoablation of liver tumors: predicting local progression on 24-hour MRI.
abstract: OBJECTIVE
  The purpose of this study was to determine which MRI features observed 24 hours after technically successful percutaneous cryoablation of liver tumors predict subsequent local tumor progression and to describe the evolution of imaging findings after cryoablation.
  
  
  METHODS
  Thirty-nine adult patients underwent technically successful imaging-guided percutaneous cryoablation of 54 liver tumors (hepatocellular carcinoma, 8; metastases, 46). MRI features pertaining to the tumor, ablation margin, and surrounding liver 24 hours after treatment were assessed independently by two readers. Fisher exact or Wilcoxon rank sum tests (significant p values < 0.05) were used to compare imaging features in patients with and without subsequent local tumor progression. Imaging features of the ablation margin, treated tumor, and surrounding liver were evaluated on serial MRI in the following year.
  
  
  RESULTS
  A minimum ablation margin of 3 mm or less was observed in 11 (78.6%) of 14 tumors with and 15 of 40 (37.5%) without progression (p = 0.012). A blood vessel bridging the ablation margin was noted in 11 of 14 (78.6%) tumors with and nine of 40 (22.5%) without progression (p < 0.001). The incidence of tumor enhancement 24 hours after cryoablation was similar for tumors with (10/14, 71.4%) or without (25/40, 62.5%) local progression (p = 0.75). MRI enabled assessment of the entire cryoablation margin in 49 of 54 (90.7%) treated tumors.
  
  
  CONCLUSIONS
  MRI features at 24 hours after liver cryoablation that were predictive of local tumor progression included a minimum ablation margin less than or equal to 3 mm and a blood vessel bridging the ablation margin. Persistent tumor enhancement is common after liver cryoablation and does not predict local tumor progression.
authors.affiliation: 1 Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115.
authors.forename: Paul B
authors.initials: PB
authors.lastname: Shyn
authors.forename: Giovanni
authors.initials: G
authors.lastname: Mauri
authors.forename: Raquel Oliva
authors.initials: RO
authors.lastname: Alencar
authors.forename: Servet
authors.initials: S
authors.lastname: Tatli
authors.forename: Shaan H
authors.initials: SH
authors.lastname: Shah
authors.forename: Paul R
authors.initials: PR
authors.lastname: Morrison
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Catalano
authors.forename: Stuart G
authors.initials: SG
authors.lastname: Silverman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003452:Cryosurgery / Q000379:methods*; D018450:Disease Progression; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D053783:Magnetic Resonance Imaging, Interventional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies
keywords: MRI; ablation procedures; cancer; gastrointestinal imaging; hepatobiliary system; vascular and interventional imaging