Computed Tomographic Appearance of Lung Tumors Treated with Percutaneous Cryoablation

作者:Ito Nobutake*; Nakatsuka Seishi; Inoue Masanori; Yashiro Hideki; Oguro Sota; Izumi Yotaro; Kawamura Masafumi; Nomori Hiroaki; Kuribayashi Sachio
来源:Journal of Vascular and Interventional Radiology, 2012, 23(8): 1043-1052.
DOI:10.1016/j.jvir.2012.04.033

摘要

Purpose: To describe the computed tomographic (CT) appearance of lung tumors treated with cryoablation to establish a reliable reference profile. %26lt;br%26gt;Materials and Methods: CT images of 56 patients who underwent follow-up CT for at least 1 year for treatment with cryoablation of 79 tumors from 2003 to 2010 were retrospectively reviewed. Patients had a follow-up CT scan immediately after the procedure; 1 day, I week (two-phase dynamic CT), and I month later; and then at 3-month intervals. The appearance of ablation zones on CT images was classified into five patterns, and bidimensional diameters and other imaging features were evaluated. %26lt;br%26gt;Results: Seventy-eight percent of ablation zones (62 of 79) showed transformation similar to the following: a consolidation or nodular pattern was seen within the I-week follow-up, involution and a %26quot;stripe%26quot; pattern was shown at 1 month or later, and zones later became indistinct. Eighty percent of cases of local progression (eight of 10) arose from the stripe pattern on follow-up CT 6 months or later, after the ablation zones showed a transformation opposite the aforementioned pattern. Ice balls could not always be visualized exactly because of dense peritumoral hemorrhage. Internal and marginal enhancement of the ablation zone within the 3-month follow-up did not show a direct relationship with local progression. In total, cavitation and peritumoral ground-glass opacity were seen in 35% (n = 28) and 85% (n = 66) of ablation zones, respectively. %26lt;br%26gt;Conclusions: The reference profile of CT appearance, which is mandatory for follow-up, has been established. No single indicator of complete ablation was proven throughout this study. Careful long-term follow-up with CT is indispensable.

  • 出版日期2012-8