A novel tool for monitoring and assessing the outcome of thermal ablations of hepatic lesions

This paper presents a proof-of-concept intervention monitoring and outcome assessment tool for thermal ablative strategies like microwave ablation of hepatic tumours. For this purpose, simulated 3D+t temperature maps of the ablation progress are combined with liver MR imaging, as well as corresponding segmentations of the lesion and other relevant anatomical structures. The proposed tool mainly consists of a monitoring and validation part, each comprising 2D and 3D visualisations and various modifiable settings. With the aid of the monitoring features, the heat propagation during the ablation progress could be visually tracked, while the validation part of the tool provides the radiologist with comprehensible and detailed feedback to assess the treatment result. Hence, it could enable an immediate validation of the ablation progress and support interventional decision-making. For evaluation purposes, we used an exemplary patient case to demonstrate the benefits of the proposed prototype. This tool could represent a crucial step towards a suitable computerassisted and more accurate workflow of thermal ablations, with benefits for both, patients and radiologists.

Hepatic Adenomatosis: Diagnosis and Management Dilemma

Hepatic adenomatosis is a rare, benign tumour of the liver. It was first described by Flejou et al as multiple adenomas in an otherwise normal liver parenchyma. Although benign, it can present as a diagnostic challenge because the lesions can be difficult to distinguish from other hepatic tumours. Patients can be asymptomatic and the diagnosis may only be made incidentally. We describe the case of 40-year-old Malay lady who was incidentally found to have hepatomegaly. Radiological examinations revealed a complex left ovarian cyst with multiple liver lesions. Biopsy of the liver lesion showed features of hepatic adenomatosis. Literature review was done and the dilemma in managing her was discussed.

Clinical practice guideline for image-guided multimode tumour ablation therapy in hepatic malignant tumours

Multimode tumour ablation therapy is a treatment method that combines cryoablation with radiofrequency ablation, guided by medical imaging technology and based on precise planning, targeting, monitoring, and control of the thermal energy delivered, with the aim of achieving a whole-body antitumour immune response to malignant tumours. To develop standardized criteria for the application of multimode tumour ablation therapy to malignant hepatic tumours, to facilitate actualization of the criteria in various hospitals, and to ensure therapeutic efficacy and safety, the Society of Interventional Therapy of the Chinese Anti-Cancer Association and the Solid Tumor Theranostics Committee of the Shanghai Anti-Cancer Association assembled experts who specialize in oncology to discuss this treatment method and to arrive at a clinical practice consensus guideline for the indications, contraindications, and techniques of multimode tumour ablation therapy for malignant hepatic tumours.