title: Imaging Features of Radiofrequency Ablation with Heat-Deployed Liposomal Doxorubicin in Hepatic Tumors.
abstract: BACKGROUND
  The imaging features of unresectable hepatic malignancies in patients who underwent radiofrequency ablation (RFA) in combination with lyso-thermosensitive liposomal doxorubicin (LTLD) were determined.
  
  
  METHODS
  A phase I dose escalation study combining RFA with LTLD was performed with peri- and post- procedural CT and MRI. Imaging features were analyzed and measured in terms of ablative zone size and surrounding penumbra size. The dynamic imaging appearance was described qualitatively immediately following the procedure and at 1-month follow-up. The control group receiving liver RFA without LTLD was compared to the study group in terms of imaging features and post-ablative zone size dynamics at follow-up.
  
  
  RESULTS
  Post-treatment scans of hepatic lesions treated with RFA and LTLD have distinctive imaging characteristics when compared to those treated with RFA alone. The addition of LTLD resulted in a regular or smooth enhancing rim on T1W MRI which often correlated with increased attenuation on CT. The LTLD-treated ablation zones were stable or enlarged at follow-up four weeks later in 69% of study subjects as opposed to conventional RFA where the ablation zone underwent involution compared to imaging acquired immediately after the procedure.
  
  
  CONCLUSIONS
  The imaging features following RFA with LTLD were different from those after standard RFA and can mimic residual or recurrent tumor. Knowledge of the subtle findings between the two groups can help avoid misinterpretation and proper identification of treatment failure in this setting. Increased size of the LTLD-treated ablation zone after RFA suggests the ongoing drug-induced biological effects.
authors.affiliation: Center for Interventional Oncology, Clinical Center, National Institutes of Health, 10 Center Drive MSC 1182, Bethesda, MD, 20892, USA. williamhongcheng@gmail.com.|Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Drive MSC 1074, Bethesda, MD, 20892, USA. williamhongcheng@gmail.com.
authors.forename: Cheng William
authors.initials: CW
authors.lastname: Hong
authors.affiliation: Center for Interventional Oncology, Clinical Center, National Institutes of Health, 10 Center Drive MSC 1182, Bethesda, MD, 20892, USA. lucychow282@gmail.com.|Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Drive MSC 1074, Bethesda, MD, 20892, USA. lucychow282@gmail.com.
authors.forename: Lucy
authors.initials: L
authors.lastname: Chow
authors.affiliation: Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Drive MSC 1074, Bethesda, MD, 20892, USA. evrimbengi@yahoo.com.
authors.forename: Evrim B
authors.initials: EB
authors.lastname: Turkbey
authors.affiliation: Division of Diagnostic Imaging and Intervention, Department of Hepatology and Liver Transplantation, Pisa University Hospital, Via Paradisa 2, Building No. 29, 56124, Pisa, Italy. riccardo.lencioni@med.unipi.it.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Lencioni
authors.affiliation: Montefiore-Einstein Center for Cancer Care, Department of Surgery, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY, 10467, USA. slibutti@montefiore.org.|National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, GB 9609 MSC 9760, Bethesda, MD, 20892, USA. slibutti@montefiore.org.
authors.forename: Steven K
authors.initials: SK
authors.lastname: Libutti
authors.affiliation: Center for Interventional Oncology, Clinical Center, National Institutes of Health, 10 Center Drive MSC 1182, Bethesda, MD, 20892, USA. bwood@nih.gov.|Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Drive MSC 1074, Bethesda, MD, 20892, USA. bwood@nih.gov.|National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, GB 9609 MSC 9760, Bethesda, MD, 20892, USA. bwood@nih.gov.
authors.forename: Bradford J
authors.initials: BJ
authors.lastname: Wood
mesh_terms: D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000628:therapy*; D017115:Catheter Ablation / Q000379:methods*; D004317:Doxorubicin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D005260:Female; D006358:Hot Temperature; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000903:Antibiotics, Antineoplastic; C506643:liposomal doxorubicin; D011092:Polyethylene Glycols; D004317:Doxorubicin
keywords: Hepatocellular carcinoma (HCC); Interventional oncology; Radiofrequency ablation; Tumor/tumour/neoplasm