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Table 3 Imaging features during follow-up per intervention

From: Follow-up after radiological intervention in oncology: ECIO-ESOI evidence and consensus-based recommendations for clinical practice

  Thermal ablation for CRLM TARE for CRLM TACE&TARE for HCC Thermal ablation for renal cancer Thermal ablation for lung cancer
CT * increase of ablation zone size
* small size difference between metastasis and ablation zone
* ablation rim discontinuity or irregular shape
* Choi outperforms RECIST 1.1 for response assessment
* arterial perfusion has potential to assess response (reduction in arterial perfusion predicts outcome in liver mets, not HCC)
* residual arterial enhancement (thick, nodular or irregular ring, especially with wash-out) * early peripheral enhancing rim that sustains after 3 months
* focal or nodular enhancement at ablation margin (enhanced > 15 HU at CT
* increase in scar volume after 2 months post-ablation
* increase in size of the ablation scar
* appearance of nodular, irregular, eccentric solid component in or at the margin of ablation zone
* new contrast enhancement > 15 HU
MRI * increase of ablation zone size
* small size difference between metastasis and ablation zon same as on CT
* T2 moderate high signal (focal, eccentric or nodular) at the margin
* persistent high signal intensity on high b-value DWI and low ADC
* disruption of the interface between ablation zone and liver parenchyma
* T1 hyperintensity > 9 months
* thickened or irregular peri-ablation zone tissue rim (low T1 & high T2)
* DWI at 4 weeks can predict outcome and potentially can outperform PET-CT
* caveat false positives due to inflammation
* same as for CT
* DWI and DCE seem promising
* same criteria as for CT
* enhancement: >15% increase in signal intensity on MRI is significant)
* after cryoablation: interrupted T2 low intensity rim
PET-CT * focal, eccentric or rim shaped FDG-uptake after 4-6 months post-ablation * reduction of ≥50% in SUVmax (FDG-PET-CT) at 4 weeks predicts outcome NA NA * new FDG uptake in the scar > 6 months after ablation
  1. Abbreviations: CRLM colorectal liver metastases, TACE transarterial chemoembolization, HCC hepatocellular carcinoma, TARE transarterial radioembolization, SIRT selective internal radiation therapy,CT computed tomography, RECIST response evaluation criteria in solid tumors, HU hounsfield units, MRI magnetic resonance imaging, DWI diffusion-weighted imaging, ADC apparent diffusion coefficient, DCE dynamic contrast-enhanced, NA not applicable, PET positron emission tomography, FDG fluorodesoxyglucose; SUVmax maximum standardized uptake value, LTP local tumor progression