Biochemical and hematologic alterations following percutaneous cryoablation of liver tumors

Experience in 48 procedures

Rashmi T. Nair, Stuart G. Silverman, Kemal Tuncali, Nancy A. Obuchowski, Eric VanSonnenberg, Sridhar Shankar

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Purpose: To retrospectively determine the frequency and severity of various abnormal laboratory test values following percutaneous cryoablation of liver tumors and to estimate the correlation between laboratory test values and tumor and ablation volumes. Materials and Methods: This HIPAA-compliant study had institutional review board approval. Informed consent was waived. Biochemical and hematologic laboratory values from 48 procedures in 39 patients (18 men and 21 women; age range, 29-86 years) who underwent magnetic resonance (MR) imaging-guided percutaneous cryoablation of 65 liver tumors (62 metastases, three hepatocellular carcinomas) were retrospectively reviewed. Changes in laboratory values at baseline and 0-6 hours and 1-2 weeks after the procedure were analyzed with respect to tumor and ablative margin volumes by using generalized estimating equations. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were correlated with percent maximal decrease in platelet count. Results: Mean ablation zone volume was 67.3 cm3 ± 41.2 (standard deviation) (range, 7.3-191.4 cm3). AST and ALT values increased after all procedures and peaked at 6 hours (median change in AST value, +835 U/L; median change in ALT value, +614.5 U/L). Platelet count decreased after 47 procedures (mean maximal decrease, 92.3 × 10 9/L [38%]), reaching a nadir at 12-24 hours after 24 procedures (50%) and returning to normal in 31 (84%) of 37 procedures at 1-2 weeks. One procedure was complicated by disseminated intravascular coagulation that necessitated transfusion and arterial embolization. Myoglobin values increased after 21 (44%) of 48 procedures and peaked at 6 hours (trimmed-mean value, 183.4 μg/L). Ablative margin volumes were predictive of changes at 0-6 hours in AST (P = .02), ALT (P = .003), and myoglobin (P -< .001) values. Percent maximal decrease in platelet count correlated with peak change in AST (r = 0.72) (P <- .001). Conclusion: Following percutaneous cryoablation of liver tumors, alterations in liver enzymes, myoglobin, and platelet count are common, are usually self-limited, and correlate with ablative margin volume - except for changes in platelet count, which correlate with changes in AST and ALT.

Original languageEnglish (US)
Pages (from-to)303-311
Number of pages9
JournalRadiology
Volume248
Issue number1
DOIs
StatePublished - Jul 1 2008

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Cryosurgery
Aspartate Aminotransferases
Liver
Alanine Transaminase
Platelet Count
Neoplasms
Myoglobin
Health Insurance Portability and Accountability Act
Disseminated Intravascular Coagulation
Research Ethics Committees
Tumor Burden
Informed Consent
Hepatocellular Carcinoma
Magnetic Resonance Imaging
Neoplasm Metastasis

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

Biochemical and hematologic alterations following percutaneous cryoablation of liver tumors : Experience in 48 procedures. / Nair, Rashmi T.; Silverman, Stuart G.; Tuncali, Kemal; Obuchowski, Nancy A.; VanSonnenberg, Eric; Shankar, Sridhar.

In: Radiology, Vol. 248, No. 1, 01.07.2008, p. 303-311.

Research output: Contribution to journalArticle

Nair, Rashmi T. ; Silverman, Stuart G. ; Tuncali, Kemal ; Obuchowski, Nancy A. ; VanSonnenberg, Eric ; Shankar, Sridhar. / Biochemical and hematologic alterations following percutaneous cryoablation of liver tumors : Experience in 48 procedures. In: Radiology. 2008 ; Vol. 248, No. 1. pp. 303-311.
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abstract = "Purpose: To retrospectively determine the frequency and severity of various abnormal laboratory test values following percutaneous cryoablation of liver tumors and to estimate the correlation between laboratory test values and tumor and ablation volumes. Materials and Methods: This HIPAA-compliant study had institutional review board approval. Informed consent was waived. Biochemical and hematologic laboratory values from 48 procedures in 39 patients (18 men and 21 women; age range, 29-86 years) who underwent magnetic resonance (MR) imaging-guided percutaneous cryoablation of 65 liver tumors (62 metastases, three hepatocellular carcinomas) were retrospectively reviewed. Changes in laboratory values at baseline and 0-6 hours and 1-2 weeks after the procedure were analyzed with respect to tumor and ablative margin volumes by using generalized estimating equations. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were correlated with percent maximal decrease in platelet count. Results: Mean ablation zone volume was 67.3 cm3 ± 41.2 (standard deviation) (range, 7.3-191.4 cm3). AST and ALT values increased after all procedures and peaked at 6 hours (median change in AST value, +835 U/L; median change in ALT value, +614.5 U/L). Platelet count decreased after 47 procedures (mean maximal decrease, 92.3 × 10 9/L [38{\%}]), reaching a nadir at 12-24 hours after 24 procedures (50{\%}) and returning to normal in 31 (84{\%}) of 37 procedures at 1-2 weeks. One procedure was complicated by disseminated intravascular coagulation that necessitated transfusion and arterial embolization. Myoglobin values increased after 21 (44{\%}) of 48 procedures and peaked at 6 hours (trimmed-mean value, 183.4 μg/L). Ablative margin volumes were predictive of changes at 0-6 hours in AST (P = .02), ALT (P = .003), and myoglobin (P -< .001) values. Percent maximal decrease in platelet count correlated with peak change in AST (r = 0.72) (P <- .001). Conclusion: Following percutaneous cryoablation of liver tumors, alterations in liver enzymes, myoglobin, and platelet count are common, are usually self-limited, and correlate with ablative margin volume - except for changes in platelet count, which correlate with changes in AST and ALT.",
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T1 - Biochemical and hematologic alterations following percutaneous cryoablation of liver tumors

T2 - Experience in 48 procedures

AU - Nair, Rashmi T.

AU - Silverman, Stuart G.

AU - Tuncali, Kemal

AU - Obuchowski, Nancy A.

AU - VanSonnenberg, Eric

AU - Shankar, Sridhar

PY - 2008/7/1

Y1 - 2008/7/1

N2 - Purpose: To retrospectively determine the frequency and severity of various abnormal laboratory test values following percutaneous cryoablation of liver tumors and to estimate the correlation between laboratory test values and tumor and ablation volumes. Materials and Methods: This HIPAA-compliant study had institutional review board approval. Informed consent was waived. Biochemical and hematologic laboratory values from 48 procedures in 39 patients (18 men and 21 women; age range, 29-86 years) who underwent magnetic resonance (MR) imaging-guided percutaneous cryoablation of 65 liver tumors (62 metastases, three hepatocellular carcinomas) were retrospectively reviewed. Changes in laboratory values at baseline and 0-6 hours and 1-2 weeks after the procedure were analyzed with respect to tumor and ablative margin volumes by using generalized estimating equations. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were correlated with percent maximal decrease in platelet count. Results: Mean ablation zone volume was 67.3 cm3 ± 41.2 (standard deviation) (range, 7.3-191.4 cm3). AST and ALT values increased after all procedures and peaked at 6 hours (median change in AST value, +835 U/L; median change in ALT value, +614.5 U/L). Platelet count decreased after 47 procedures (mean maximal decrease, 92.3 × 10 9/L [38%]), reaching a nadir at 12-24 hours after 24 procedures (50%) and returning to normal in 31 (84%) of 37 procedures at 1-2 weeks. One procedure was complicated by disseminated intravascular coagulation that necessitated transfusion and arterial embolization. Myoglobin values increased after 21 (44%) of 48 procedures and peaked at 6 hours (trimmed-mean value, 183.4 μg/L). Ablative margin volumes were predictive of changes at 0-6 hours in AST (P = .02), ALT (P = .003), and myoglobin (P -< .001) values. Percent maximal decrease in platelet count correlated with peak change in AST (r = 0.72) (P <- .001). Conclusion: Following percutaneous cryoablation of liver tumors, alterations in liver enzymes, myoglobin, and platelet count are common, are usually self-limited, and correlate with ablative margin volume - except for changes in platelet count, which correlate with changes in AST and ALT.

AB - Purpose: To retrospectively determine the frequency and severity of various abnormal laboratory test values following percutaneous cryoablation of liver tumors and to estimate the correlation between laboratory test values and tumor and ablation volumes. Materials and Methods: This HIPAA-compliant study had institutional review board approval. Informed consent was waived. Biochemical and hematologic laboratory values from 48 procedures in 39 patients (18 men and 21 women; age range, 29-86 years) who underwent magnetic resonance (MR) imaging-guided percutaneous cryoablation of 65 liver tumors (62 metastases, three hepatocellular carcinomas) were retrospectively reviewed. Changes in laboratory values at baseline and 0-6 hours and 1-2 weeks after the procedure were analyzed with respect to tumor and ablative margin volumes by using generalized estimating equations. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were correlated with percent maximal decrease in platelet count. Results: Mean ablation zone volume was 67.3 cm3 ± 41.2 (standard deviation) (range, 7.3-191.4 cm3). AST and ALT values increased after all procedures and peaked at 6 hours (median change in AST value, +835 U/L; median change in ALT value, +614.5 U/L). Platelet count decreased after 47 procedures (mean maximal decrease, 92.3 × 10 9/L [38%]), reaching a nadir at 12-24 hours after 24 procedures (50%) and returning to normal in 31 (84%) of 37 procedures at 1-2 weeks. One procedure was complicated by disseminated intravascular coagulation that necessitated transfusion and arterial embolization. Myoglobin values increased after 21 (44%) of 48 procedures and peaked at 6 hours (trimmed-mean value, 183.4 μg/L). Ablative margin volumes were predictive of changes at 0-6 hours in AST (P = .02), ALT (P = .003), and myoglobin (P -< .001) values. Percent maximal decrease in platelet count correlated with peak change in AST (r = 0.72) (P <- .001). Conclusion: Following percutaneous cryoablation of liver tumors, alterations in liver enzymes, myoglobin, and platelet count are common, are usually self-limited, and correlate with ablative margin volume - except for changes in platelet count, which correlate with changes in AST and ALT.

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