Tumor Contraction-Aware Multi-Sequence MRI Framework for Accurate Post-Ablation Margin Assessment in Hepatocellular Carcinoma.

Hepatocellular carcinoma (HCC) is a major cause of cancer-related mortality, and microwave ablation (MWA) is commonly used for patients ineligible for surgical resection. A critical challenge following MWA is the assessment of the ablative margin, which is complicated by non-diffeomorphic deformations introduced by thermal effects during the procedure. This paper proposes a Multi-sequence Distance-guided Complementary Network (MDCNet) that utilizes multi-sequence MRI to quantify the extent of tumor contraction after MWA. To account for the differential contraction responses of liver parenchyma and tumor tissue, we propose a novel distance-aware mask transformation strategy. This method explicitly models the spatial attenuation of MWA energy and approximates the influence of liver parenchyma's linear elastic response on tumor shrinkage, thereby enhancing the spatial adaptiveness of feature weighting. To capture the distinct structural characteristics of liver tissue emphasized by different MRI sequences and to leverage their complementary information, a gated channel fusion module is introduced to dynamically integrate features from delayed-phase and T2-weighted images. To validate the practical effectiveness of our proposed method, we evaluate the ablative margins of 115 HCC patients using a fine-tuned TransMorph model that incorporated tumor contraction predictions generated by MDCNet, and compare the results with radiologist 2D assessments. The registration method enhanced with MDCNet improved tumor deformation accuracy and achieved a higher Youden Index in detecting incomplete ablations. Moreover, MDCNet provides interpretable predictions, thereby facilitating clinical decision support.