Early assessment of coagulation necrosis after hepatic microwave ablation: a comparison of non-enhanced and enhanced T1-weighted images.
To compare the technical success and accuracy of hepatic microwave ablation (MWA) using non-enhanced and enhanced T1-weighted imaging early after ablation. Patients were evaluated with regard to the ablation zone and local tumor progression (LTP).



This retrospective study conducted between September 2014 and December 2015 which consisted of 56 patients with 56 hepatic malignant lesions who underwent percutaneous MWA. Non-enhanced and contrast-enhanced T1-weighted imagings were performed within 2 days after tumor ablation. The efficacy of ablation assessed according to the hyperintense middle zone on non-enhanced T1-weighted images and the non-enhanced area on contrast-enhanced T1-weighted images were compared. The development of LTP during ≥7 months of follow-up served as the end point.



On the non-enhanced T1-weighted images, the ablated region had a characteristic two-zone structure featuring a hyperintense middle zone and a surrounding hypointense band. Among the 56 patients, LTP developed in ten including seven lesions, in which both the non-enhanced T1-weighted and portal-phase images showed incomplete tumor ablation. In two of the remaining three patients, incomplete tumor ablation was detected on the non-enhanced T1-weighted images, whereas the corresponding portal-phase images showed complete ablation. In the remaining patient, no residual tumor was detected on either the non-enhanced T1-weighted or the portal-phase images. In the 46 patients without LTP, there was no evidence of residual tumor on the non-enhanced T1-weighted or portal-phase images obtained early after ablation.



Non-enhanced T1-weighted images are useful in assessing the therapeutic efficacy of MWA of liver tumors early after the procedure.
Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Gulou district, Nanjing, 210029, Jiangsu, China.
Zhen-Yu
ZY
Jia
Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Gulou district, Nanjing, 210029, Jiangsu, China.
Qi-Feng
QF
Chen
Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Gulou district, Nanjing, 210029, Jiangsu, China. ntdoctoryang@hotmail.com.
Zheng-Qiang
ZQ
Yang
Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Gulou district, Nanjing, 210029, Jiangsu, China.
Wen-Tao
WT
Wu
Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Gulou district, Nanjing, 210029, Jiangsu, China.
Hai-Bin
HB
Shi
Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Gulou district, Nanjing, 210029, Jiangsu, China.
Sheng
S
Liu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000379:methods*; D003287:Contrast Media; D018450:Disease Progression; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D009336:Necrosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D019786:Gadolinium DTPA
Ablation; Liver tumor; MRI; Microwave