Assessment of Ablative Margin After Microwave Ablation for Hepatocellular Carcinoma Using Deep Learning-Based Deformable Image Registration
Aim: To assess the ablative margin (AM) after microwave ablation (MWA) for hepatocellular carcinoma (HCC) with a deep learning-based deformable image registration (DIR) technique and analyze the relation between the AM and local tumor progression (LTP).Patients and Methods: From November 2012 to Apr...
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Frontiers Media S.A.
2020-09-01
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Series: | Frontiers in Oncology |
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Online Access: | https://www.frontiersin.org/article/10.3389/fonc.2020.573316/full |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Chao An Yiquan Jiang Zhimei Huang Yangkui Gu Tianqi Zhang Ling Ma Jinhua Huang |
spellingShingle |
Chao An Yiquan Jiang Zhimei Huang Yangkui Gu Tianqi Zhang Ling Ma Jinhua Huang Assessment of Ablative Margin After Microwave Ablation for Hepatocellular Carcinoma Using Deep Learning-Based Deformable Image Registration Frontiers in Oncology microwave ablation deep learning-based deformable image registration ablative margin hepatocellular carcinoma local tumor progression |
author_facet |
Chao An Yiquan Jiang Zhimei Huang Yangkui Gu Tianqi Zhang Ling Ma Jinhua Huang |
author_sort |
Chao An |
title |
Assessment of Ablative Margin After Microwave Ablation for Hepatocellular Carcinoma Using Deep Learning-Based Deformable Image Registration |
title_short |
Assessment of Ablative Margin After Microwave Ablation for Hepatocellular Carcinoma Using Deep Learning-Based Deformable Image Registration |
title_full |
Assessment of Ablative Margin After Microwave Ablation for Hepatocellular Carcinoma Using Deep Learning-Based Deformable Image Registration |
title_fullStr |
Assessment of Ablative Margin After Microwave Ablation for Hepatocellular Carcinoma Using Deep Learning-Based Deformable Image Registration |
title_full_unstemmed |
Assessment of Ablative Margin After Microwave Ablation for Hepatocellular Carcinoma Using Deep Learning-Based Deformable Image Registration |
title_sort |
assessment of ablative margin after microwave ablation for hepatocellular carcinoma using deep learning-based deformable image registration |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Oncology |
issn |
2234-943X |
publishDate |
2020-09-01 |
description |
Aim: To assess the ablative margin (AM) after microwave ablation (MWA) for hepatocellular carcinoma (HCC) with a deep learning-based deformable image registration (DIR) technique and analyze the relation between the AM and local tumor progression (LTP).Patients and Methods: From November 2012 to April 2019, 141 consecutive patients with single HCC (diameter ≤ 5 cm) who underwent MWA were reviewed. Baseline characteristics were collected to identify the risk factors for the determination of LTP after MWA. Contrast-enhanced magnetic resonance imaging scans were performed within 1 month before and 3 months after treatment. Complete ablation was confirmed for all lesions. The AM was measured based on the margin size between the tumor region and the deformed ablative region. To correct the misalignment, DIR between images before and after ablation was achieved by an unsupervised landmark-constrained convolutional neural network. The patients were classified into two groups according to their AMs: group A (AM ≤ 5 mm) and group B (AM > 5 mm). The cumulative LTP rates were compared between the two groups using Kaplan–Meier curves and the log-rank test. Multivariate analyses were performed on clinicopathological variables to identify factors affecting LTP.Results: After a median follow-up period of 28.9 months, LTP was found in 19 patients. The mean tumor and ablation zone sizes were 2.3 ± 0.9 cm and 3.8 ± 1.2 cm, respectively. The mean minimum ablation margin was 3.4 ± 0.7 mm (range, 0–16 mm). The DIR technique had higher AUC for 2-year LTP without a significant difference compared with the registration assessment without DL (P = 0.325). The 6-, 12-, and 24-month LTP rates were 9.9, 20.6, and 24.8%, respectively, in group A, and 4.0, 8.4, and 8.4%, respectively, in group B. There were significant differences between the two groups (P = 0.011). Multivariate analysis showed that being >65 years of age (P = 0.032, hazard ratio (HR): 2.463, 95% confidence interval (CI), 1.028–6.152) and AM ≤ 5 mm (P = 0.010, HR: 3.195, 95% CI, 1.324–7.752) were independent risk factors for LTP after MWA.Conclusion: The novel technology of unsupervised landmark-constrained convolutional neural network-based DIR is feasible and useful in evaluating the ablative effect of MWA for HCC. |
topic |
microwave ablation deep learning-based deformable image registration ablative margin hepatocellular carcinoma local tumor progression |
url |
https://www.frontiersin.org/article/10.3389/fonc.2020.573316/full |
work_keys_str_mv |
AT chaoan assessmentofablativemarginaftermicrowaveablationforhepatocellularcarcinomausingdeeplearningbaseddeformableimageregistration AT yiquanjiang assessmentofablativemarginaftermicrowaveablationforhepatocellularcarcinomausingdeeplearningbaseddeformableimageregistration AT zhimeihuang assessmentofablativemarginaftermicrowaveablationforhepatocellularcarcinomausingdeeplearningbaseddeformableimageregistration AT yangkuigu assessmentofablativemarginaftermicrowaveablationforhepatocellularcarcinomausingdeeplearningbaseddeformableimageregistration AT tianqizhang assessmentofablativemarginaftermicrowaveablationforhepatocellularcarcinomausingdeeplearningbaseddeformableimageregistration AT lingma assessmentofablativemarginaftermicrowaveablationforhepatocellularcarcinomausingdeeplearningbaseddeformableimageregistration AT jinhuahuang assessmentofablativemarginaftermicrowaveablationforhepatocellularcarcinomausingdeeplearningbaseddeformableimageregistration |
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doaj-223c00d6528e4ac68e40d57073f5b0702020-11-25T03:34:43ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2020-09-011010.3389/fonc.2020.573316573316Assessment of Ablative Margin After Microwave Ablation for Hepatocellular Carcinoma Using Deep Learning-Based Deformable Image RegistrationChao An0Yiquan Jiang1Zhimei Huang2Yangkui Gu3Tianqi Zhang4Ling Ma5Jinhua Huang6Department of Minimal Invasive Intervention, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Minimal Invasive Intervention, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Minimal Invasive Intervention, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Minimal Invasive Intervention, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Minimal Invasive Intervention, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, ChinaCollege of Software, Nankai University, Tianjin, ChinaDepartment of Minimal Invasive Intervention, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, ChinaAim: To assess the ablative margin (AM) after microwave ablation (MWA) for hepatocellular carcinoma (HCC) with a deep learning-based deformable image registration (DIR) technique and analyze the relation between the AM and local tumor progression (LTP).Patients and Methods: From November 2012 to April 2019, 141 consecutive patients with single HCC (diameter ≤ 5 cm) who underwent MWA were reviewed. Baseline characteristics were collected to identify the risk factors for the determination of LTP after MWA. Contrast-enhanced magnetic resonance imaging scans were performed within 1 month before and 3 months after treatment. Complete ablation was confirmed for all lesions. The AM was measured based on the margin size between the tumor region and the deformed ablative region. To correct the misalignment, DIR between images before and after ablation was achieved by an unsupervised landmark-constrained convolutional neural network. The patients were classified into two groups according to their AMs: group A (AM ≤ 5 mm) and group B (AM > 5 mm). The cumulative LTP rates were compared between the two groups using Kaplan–Meier curves and the log-rank test. Multivariate analyses were performed on clinicopathological variables to identify factors affecting LTP.Results: After a median follow-up period of 28.9 months, LTP was found in 19 patients. The mean tumor and ablation zone sizes were 2.3 ± 0.9 cm and 3.8 ± 1.2 cm, respectively. The mean minimum ablation margin was 3.4 ± 0.7 mm (range, 0–16 mm). The DIR technique had higher AUC for 2-year LTP without a significant difference compared with the registration assessment without DL (P = 0.325). The 6-, 12-, and 24-month LTP rates were 9.9, 20.6, and 24.8%, respectively, in group A, and 4.0, 8.4, and 8.4%, respectively, in group B. There were significant differences between the two groups (P = 0.011). Multivariate analysis showed that being >65 years of age (P = 0.032, hazard ratio (HR): 2.463, 95% confidence interval (CI), 1.028–6.152) and AM ≤ 5 mm (P = 0.010, HR: 3.195, 95% CI, 1.324–7.752) were independent risk factors for LTP after MWA.Conclusion: The novel technology of unsupervised landmark-constrained convolutional neural network-based DIR is feasible and useful in evaluating the ablative effect of MWA for HCC.https://www.frontiersin.org/article/10.3389/fonc.2020.573316/fullmicrowave ablationdeep learning-based deformable image registrationablative marginhepatocellular carcinomalocal tumor progression |