Application of Gemstone CT Spectroscopy in the Evaluation of Abnormal Enhancement of Lesion Margin After Radiofrequency Ablation of Hepatocellular Carcinoma

Abstract

Background: Accurately assessing the efficacy of radiofrequency ablation for hepatocellular carcinoma (HCC), and early detection of tumor residues or recurrence after radiofrequency ablation is important to improve the prognosis of patients with HCC. Objectives: To investigate the application of gemstone spectral imaging in the evaluation of abnormal enhancement of the edge of HCC after radiofrequency ablation. Patients and Methods: From November 2013 to April 2019, patients with HCC admitted to the department underwent regular gemstone spectral imaging and energy spectrum analysis after radiofrequency ablation. The abnormal enhancement within and around the radiofrequency ablation lesion was observed, and the energy spectrum data of the radiofrequency ablation lesion and the abnormal enhancement focus were measured. Results: A total of 133 lesions with marginal enhancement following radiofrequency ablation were included. Of these lesions, 62 were eventually diagnosed as inflammatory reaction zone, and 71 were diagnosed as residual or recurrent HCC. The results of energy spectrum analysis showed that there was a statistically significant difference in the iodine concentration between the inflammatory reaction zone and the residual or recurrent HCC (P < 0.001). The iodine concentration in the inflammatory reaction zone was lower than the iodine concentration in the residual or recurrent HCC (9.70±3.00 100 µg/mL vs. 13.24 ± 4.51 100 µg/mL). In the enhanced arterial and portal venous phases, the difference between the slope of the energy spectrum curve of the inflammatory reaction zone and the residual or recurrent HCC was statistically significant (P < 0.001). Conclusion: Gemstone spectral imaging can effectively differentiate residual or recurrent HCC from the inflammatory reaction zone after radiofrequency ablation. It is conducive to early detection of residual or recurrent tumors, helps clinicians formulate the next treatment plan, and improves the prognosis of patients.