Quantitative volumetric assessment of percutaneous image-guided microwave ablations for colorectal liver metastases

Abstract

Thermal ablations are becoming an increasingly common alternative treatment to surgery in patients with primary and secondary hepatic tumors. In image-guided percutaneous ablations of liver tumors, the technical post-interventional success of ablation treatment is defined by achieving complete tumor destruction and an ablation margin of at least 5 mm. Therefore, it is crucial that proper ablation verification is ensured intra-operatively or immediately post-operatively. In the current setting, the ablation-tumor coverage is visually evaluated by an interventional radiologist who compares the differences between the pre- and post-ablation images. To address this limitation, we have developed an image analysis pipeline consisting of a set of quantitative methods for evaluating the volumetric coverage of the ablation, which could be added to image-guidance systems. In this work, we present the quantitative ablation evaluation method and preliminary results after applying it to a retrospective cohort of 100 patients that were treated with image-guided percutaneous ablations for colorectal liver metastasis.