Retrospective Review of Efficacy of Radiofrequency Ablation for Treatment of Colorectal Cancer Liver Metastases From a Canadian Perspective Benjamin.

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Retrospective Review of Efficacy of Radiofrequency Ablation for Treatment of Colorectal Cancer Liver Metastases From a Canadian Perspective Benjamin Y.M. Kwan, MD, Ania Z. Kielar, MD, Robert H. El-Maraghi, MD, Lourdes M. Garcia, PhD Canadian Association of Radiologists Journal Volume 65, Issue 1, Pages 77-85 (February 2014) DOI: 10.1016/j.carj.2012.02.002 Copyright © 2014 Canadian Association of Radiologists Terms and Conditions

Figure 1 (A) Axial computed tomography image before radiofrequency ablation (RFA) of a colorectal cancer liver metastases (CCLM) lesion (black arrows). (B) Axial magnetic resonance imaging before RFA of CCLM (a different lesion than [A]) (white arrow). Canadian Association of Radiologists Journal 2014 65, 77-85DOI: (10.1016/j.carj.2012.02.002) Copyright © 2014 Canadian Association of Radiologists Terms and Conditions

Figure 2 (A) Ultrasonographic (US) planning for radiofrequency ablation (RFA) of the colorectal cancer liver metastases (CCLM) lesion (white arrow) next to the right hepatic vein which is a heat sink (black arrow). (B) US image immediately after RFA (white arrow). (C) Axial contrast-enhanced computed tomography image, showing residual CCLM (black arrow) next to the ablated area (white arrow). Canadian Association of Radiologists Journal 2014 65, 77-85DOI: (10.1016/j.carj.2012.02.002) Copyright © 2014 Canadian Association of Radiologists Terms and Conditions

Figure 3 Axial computed tomography image, showing post–radiofrequency ablation site (black arrows). Canadian Association of Radiologists Journal 2014 65, 77-85DOI: (10.1016/j.carj.2012.02.002) Copyright © 2014 Canadian Association of Radiologists Terms and Conditions

Figure 4 (A) Axial computed tomography (CT) image before radiofrequency ablation (RFA), showing no peri-inferior vena cava lesion (black arrow), but there is one in the right lobe of the liver (white arrow). (B) Axial CT image after RFA (white arrow), showing a new peri-inferior vena cava lesion (black arrow). Canadian Association of Radiologists Journal 2014 65, 77-85DOI: (10.1016/j.carj.2012.02.002) Copyright © 2014 Canadian Association of Radiologists Terms and Conditions

Figure 5 Kaplan-Meier graph of tumour-free survival. Average (SE) tumour-free survival was 14.44 ± 1.35 months (range, 1-43 months), with a median (SE) of 8.00 ± 1.07 months. Canadian Association of Radiologists Journal 2014 65, 77-85DOI: (10.1016/j.carj.2012.02.002) Copyright © 2014 Canadian Association of Radiologists Terms and Conditions

Figure 6 Kaplan-Meier graph of recurrence-free survival. Average (SE) recurrence-free survival was 33.53 ± 2.29 months (range, 2-50 months), with a median (SE) of 32.00 ± 2.69 months. Canadian Association of Radiologists Journal 2014 65, 77-85DOI: (10.1016/j.carj.2012.02.002) Copyright © 2014 Canadian Association of Radiologists Terms and Conditions

Figure 7 Kaplan-Meier graph of overall survival. Overall survival was 89.36% at 1 year, 70.00% at 2 years, and 38.10% at 3 years. Average (SE) overall survival was 36.95 ± 2.84 months, with a median (SE) of 39.00 ± 4.01 months. Canadian Association of Radiologists Journal 2014 65, 77-85DOI: (10.1016/j.carj.2012.02.002) Copyright © 2014 Canadian Association of Radiologists Terms and Conditions

Figure 8 Axial (A) and coronal (B) magnetic resonance imaging, demonstrating an example of tract seeding. There is an enhancing nodule in the subcutaneous tissues (white arrow) along the tract of previous radiofrequency ablation (black arrow), which indicates tract seeding. Canadian Association of Radiologists Journal 2014 65, 77-85DOI: (10.1016/j.carj.2012.02.002) Copyright © 2014 Canadian Association of Radiologists Terms and Conditions

Figure 9 Coronal image on magnetic resonance imaging of a local recurrence. There is a halo-type recurrence as previously described by Chopra et al [13] (black arrow and arrowheads), indicating local recurrence around the previously treated colorectal cancer metastasis to the liver (white arrow). Canadian Association of Radiologists Journal 2014 65, 77-85DOI: (10.1016/j.carj.2012.02.002) Copyright © 2014 Canadian Association of Radiologists Terms and Conditions