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Master Thesis

Software-based assessment of margin in hepatocellular carcinoma and liver metastases after percutaneous thermal ablation: a systematic review

Abstract : Purpose: to conduct a comprehensive review of clinical studies evaluating software or a new method for margin assessment after percutaneous thermoablation (PTA) of liver tumors. Materials and methods: three databases were used: Pubmed/MEDLINE, Embase and The Cochrane Library. Keywords were “software”, “ablation techniques”, “liver neoplasms”, "image processing”, “imaging, three-dimensional”, “volumetric assessment”, “ablation”, “ablative margin”, “local tumor progression”, “radiofrequency ablation”. Following criteria were: liver tumor treated by a thermoablation technique, at least 10 patients included, fusion of pre- and post-treatment CT, MRI or ConeBeam-CT images, post-ablation margin studies, description of technique used. After exhaustive extraction of data from articles, they were analyzed and grouped into tables in order to homogenize and synthesize data. Results: 678 articles were recorded. After applying exclusion criteria, 28 references were included. All studies were single-center, only 2 were prospective. Majority were feasibility (89.29%) or predictive (78.57%) studies. Four softwares were able to generate automatically margins. Time for use was inhomogeneously reported, ranged between 5–30 min (or more). Inter-operator reproducibility was high (k range: 0.686–1). Ascites, liver deformation, different position or undetectable tumor were major factor of error of coregistration. Margin was often the only significant risk factor for LTP. Visual assessment tended to overestimate assessment of margin. Mostly, LTP occurred at the location of thinnest margin or residual tumor. Conclusion: ablation margin is an independent risk factor for LTP. The therapeutic impact of margin assessment software should therefore be of major importance. The ideal ablation confirmation software would imply a fast and easy to use workflow, as automatic as possible, with high precision.
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Master Thesis
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Contributor : Faculté de Médecine Um Connect in order to contact the contributor
Submitted on : Wednesday, November 3, 2021 - 12:11:50 PM
Last modification on : Saturday, November 6, 2021 - 3:21:36 AM


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Chloé Minier. Software-based assessment of margin in hepatocellular carcinoma and liver metastases after percutaneous thermal ablation: a systematic review. Human health and pathology. 2021. ⟨dumas-03412774⟩



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